Factors related to the choice of family medicine: A reassessment and literature review

Background: Recent decreases in the number of students entering family medicine has prompted reconsideration of what is known about the factors affecting specialty choice. Methods: Thirty-six articles on family medicine specialty choice published since 1993 were reviewed and rated for quality. Results: Rural background related positively and parents' socioeconomic status relates negatively to choice of family medicine. Career intentions at entry to medical school predict specialty choice. Students who believe primary care is important, have low income expectations, and do not plan a research career are more likely to choose family medicine. The school characteristic related to choice of family medicine is public ownership. Large programs to increase numbers entering primary care seem effective. Required family medicine time in clinical years is related to higher numbers selecting family medicine. Faculty role models serve both as positive and negative influences. Students rejecting family medicine are concerned about prestige, low income, and breadth of knowledge required. Students planning on a career in a disadvantaged or rural area are more likely to enter family medicine. Conclusions: Multiple factors are consistently shown to be related to the choice of the specialty of family medicine.