COMPARISONS BETWEEN OLDER AND USUAL-AGED MEDICAL-SCHOOL GRADUATES ON THE FACTORS INFLUENCING THEIR CHOICES OF PRIMARY-CARE SPECIALTIES

Purpose. To examine whether there are differences between older (30+ y ears) and usual-aged graduates in the factors that influence their dec isions to enter primary care. Method. A national survey of primary car e physicians was conducted by mail in early 1993. The survey populatio n comprised physicians who had graduated from U.S. allopathic medical schools in 1983 and 1984. The questionnaire consisted of four parts: p ractice characteristics, 19 variables influencing the physicians' deci sions to enter primary care (rated on a scale from 5 = very strong inf luence to 1 = no influence), the timing of the decision to enter prima ry care, and demographic and personal information. Data were analyzed through several statistical methods. Results. In all, 355 (22%) older and 1,241 (78%) usual-aged graduates who were practicing in primary ca re specialties responded. Compared with the usual-aged graduates, the older graduates were more likely to have grown up in rural or inner-ci ty areas, to have obtained a second academic degree, and to have made the decision to enter primary care earlier. The older graduates' decis ions to enter primary care had been more influenced by children and fa milial responsibilities, whereas the usual-aged graduates had been mor e influenced by internship and residency experiences and by parents an d role models before medical school. Conclusion. This study provides e mpirical evidence to support the notion that nontraditional students ( i.e., older ones) are more likely to commit themselves earlier to a ca reer decision and less likely to be influenced by the socialization pr ocess during medical school. In this regard, age-specific factors shou ld receive more attention in the analysis of the physician workforce.