Quality of a family medicine preceptorship is significantly associated with matching into family practice.

OBJECTIVES This study tested whether clinical experiences in family practice are associated with matching into family practice. METHODS We conducted a prospective cohort study of 913 medical students who completed the Family Practice Preceptorship (FPP) at the University of Iowa from 1990-1996. Using univariate techniques and logistic regression, we compared the background and experiences of those who matched into family practice with those who chose other specialties. RESULTS Twenty-nine percent (n=267) matched into family practice. Positive independent predictors of family practice match were hometown size less than 10,000 (odds ratio [OR] 1.8), anticipating choosing family practice at matriculation (OR 4.2), and liking to help others (OR 4.1). Negative independent predictors included parental income of at least $120,000 (OR .61), desiring to perform technical procedures (OR .51), and liking the scientific method and research (OR .54). The effect of an early summer clinical experience at a community hospital varied depending on the level of student interest in family practice at matriculation. Students who rated the educational value of the FPP as high or very high were significantly more likely to go into family practice (OR 2.9), even after adjusting for all other student characteristics. CONCLUSIONS A number of student characteristics and preferences, early clinical experiences, and the perceived quality of a required family medicine preceptorship were significantly and independently associated with students matching into family practice.