Evaluation of Curricular Factors that Impact Residency Specialty Choice
Authors: Kim Leah , Nichols Carol A , Edmondson Anna C 
Published: November 2023

Introduction

Physician shortages are not only a national issue but also a problem faced by the state of Georgia, ranking 39th in the ratio of doctors per 100,000 population. A 2010 report by the Georgia Board for Physician Workforce found that many rural counties lacked both primary care and surgical physicians. More specifically, 6 counties lacked family medicine physicians, 31 had no internal medicine physicians, 79 had no OB/GYNs, and 66 had no general surgeons. When applying to residency programs, students consider multiple influences including sociodemographic and curriculum factors before making their decision. As Georgia's only public medical school, the Medical College of Georgia (MCG) could play an influential role in alleviating the state's healthcare needs by influencing student's residency specialty choice at the level of the medical school curriculum.

Purpose and Hypothesis

The purpose of the study is to evaluate what factors influence a student's interest in a residency specialty during the first year of medical school. We hypothesize that components such as anatomy and physiology that are taught in the first year curriculum may positively influence a student's future residency choice.

Methods

An anonymous online survey was administered to MCG Class of 2019 medical students at the end of the first year curriculum (n=193). 80 (41% of class) responses were collected. The survey consists of 53 questions targeting sociodemographic factors, the medical school curriculum, and other experiences that may influence residency interest. Free response questions were themed and quantified for analysis. Likert scale data were averaged and analyzed using a two‐tail, two‐sample t‐test.

Results

Upon entering medical school, 42.5% of respondents were interested in pursuing primary care, 45% were interested in a specialty, and 12.5% were undecided. Over the course of the year, 41% of students changed their residency choice, with 40% choosing primary care, 48.8% choosing a specialty, and 11.25% still undecided. Students indicated that the first year curriculum (44.4%) influenced their program decisions more than factors like clinical exposure (25.9%), interest group experiences (2.8%), and nature of the residency choice (27.8%). Within the curriculum, the majority of students felt that both the content covered and their performance in anatomy (3.8, 3.6), physiology (3.9, 3.8), and neuroscience (3.6, 3.6) components had a more significant positive influence on their residency choice compared to biochemistry, histology, and development (p < 0.05). Students interested in surgical or radiology residencies indicated that their choices were more positively influenced by both anatomy content and their anatomy performance (4.2, 4.1; p<0.05) compared to students interested in non‐surgical fields (3.6, 3.3). In contrast, students interested in non‐surgical fields were more positively influenced by physiology content (4.0, p<0.05) and neuroscience content and performance (3.9, 3.8, p<0.05).

Conclusion

Curricular factors appear to have a notable effect on students & their future medical careers. Due to changing shortages of primary care providers & specialists, it is imperative that schools continue working towards alleviating state and national healthcare needs through factors like medical school admissions, clinical training, and academic curriculum development.