The Effect of Rural Training Experiences During Residency on the Selection of Primary Care Careers: A Retrospective Cohort Study From a Single Large Internal Medicine Residency Program

Background: Little is known about the factors during internal medicine residency that influence career choice. Purpose: To determine if rural training experiences were associated with primary care career choice. Methods: We conducted a retrospective cohort study at a single, large, internal medicine residency program. We reviewed self-reported career plan at the time of graduation. Independent variables obtained from curricular data included track (categorical or primary care), gender, year of graduation, timing of clinic block, and having had a rural training experience. We studied 451 program graduates who completed all three years of training between the years 1996 and 2006. Results: Factors associated with an intended primary care career at the time of graduation were: primary care track (OR 4.5, 95% CI 2.4-8.6) and a rural training experience (OR 2.1, 95% CI 1.3-3.4). Conclusions: These data suggest that provision of more rural training experiences might increase interest in primary care careers.