Factors affecting specialty choice among osteopathic medical students

Acad Med. 2009 Jun;84(6):718-23. doi: 10.1097/ACM.0b013e3181a43c60.


Purpose: The availability of primary care directly and favorable affects the health status of local communities. This study shows the predictors and characteristics of osteopathic medical students who chose a primary care specialty (PCS).

Method: The authors surveyed 2,345 fourth-year osteopathic medical students during 2003-2004. A total of 1,882 (80%) responded. By means of their survey, the authors examined many aspects of the students' experiences and other factors in relation to choice of a PCS versus a nonprimary nonsurgical specialty (NPCS) and compared their findings against findings in the allopathic specialty-choice literature.

Results: Dealing with people was favored by those entering a PCS, whereas the NPCS group cited technical skills, prestige and income, and lifestyle as being highly influential. Both PCS and NPCS respondents favored dually accredited programs (American Osteopathic Association-Accreditation Council for Graduate Medical Education). Women showed a slightly greater preference for a PCS, whereas men overwhelmingly chose an NPCS. Those who anticipated practicing in cities of fewer than 100,000 citizens tended to choose a PCS. Those individuals choosing a PCS expect their income to be less than those choosing an NPCS. Debt showed a monotonic influence on specialty choice, with respondents who had greater debt favoring NPCSs.

Conclusions: No single factor reliably predicts specialty choice; it is a complex decision-making process. There are modifiable factors (debt) and nonmodifiable factors (gender) that influence specialty choice. The study's findings suggest that positively influencing the modifiable risk factors will increase the probability but not the certainty of osteopathic medical students' choosing a PCS.

Publication types

  • Comparative Study

MeSH terms

  • Career Choice*
  • Data Collection
  • Decision Making
  • Education, Medical, Graduate / statistics & numerical data*
  • Female
  • Health Workforce
  • Humans
  • Male
  • Osteopathic Medicine / education*
  • Predictive Value of Tests
  • Primary Health Care*
  • Probability
  • Risk Factors
  • Schools, Medical
  • Specialization
  • Students, Medical / statistics & numerical data*
  • Surveys and Questionnaires
  • United States
  • Young Adult