PREDICTIVE-VALIDITY OF MEDICAL-STUDENT CHOICES OF PRACTICE LOCATION

We compared University of Alabama medical students' 1980-1981 practice location and specialty preferences with actual practice locations and specialties in 1991 with the following results. (1) Primary care phys icians were located mostly in small or large communities, whereas larg er than expected numbers of subspecialists practiced in smaller cities . (2) Actual proportions in primary care and surgical subspecialties w ere less than in earlier preferences; more than expected chose nonsurg ical subspecialties. (3) Large city practice locations showed an incre ase in 1991 at the expense of earlier preferences for medium-sized cit ies. We suggest that the shift of primary care physicians to larger ci ties reflects concerns about the financial viability of small town pra ctice, coupled with greater earning in affluent suburbs. Excess number s of subspecialists in smaller locations may be due to a perceived ove rsupply of subspecialists in larger cities.