FINANCIAL INCENTIVES IN RESIDENCY RECRUITING FOR PRIMARY-CARE - SCOPE, CHARACTERISTICS, AND STUDENTS PERCEPTIONS

One response to the decline in interest among medical students in resi dency training in primary care has been the offering, by residency pro grams and hospitals, of financial recruitment incentives to medical st udents during their residency interviews. Few data on the breadth and effectiveness of this practice have been available. Method. To gain in sight into how hospitals and/or programs offered incentives, the autho rs compared 1990 and 1992 survey data on this topic from the members o f the Association of American Medical Colleges' Council of Teaching Ho spitals (AAMC/COTH) with 1992 data from the members of the Association for Hospital Medical Education (AHME), employing responses to identic al questionnaire items. Complementary data on students' experiences wi th recruitment incentives in 1991 and 1992 were also analyzed. These d ata have been collected since 1991 in the Medical School Graduation Qu estionnaire (GQ) of the AAMC's Section for Educational Research, but l ittle or no information had been available on medical students' percep tions of the effectiveness of these incentives. Therefore, one of the authors surveyed members of the classes of 1992 at four Midwestern med ical schools about their residency interviewing experiences, including their reactions to financial incentives they encountered. Results. Th e outcomes from these surveys indicate that, as expected, family pract ice, internal medicine, and pediatrics were the specialties most likel y to offer financial incentives; that a wide variety of recruitment in centives was available to students; that the proportion of programs an d hospitals offering such incentives was increasing (e.g., from 37% in the 1990 COTH survey to 54% in the 1992 survey); and that a large maj ority (79%) of students who encountered these incentives viewed them a s at least somewhat effective in persuading them to consider matching with the programs that offered them. Conclusion, The prevalence and pe rsuasiveness of financial incentives raise a number of serious questio ns, including whether competition for residents will divert funds from improving educational quality to recruitment.