Addressing the Enduring Primary Care Physician Shortage in The United States: The Direct and Indirect Effects of Gender on the Medical Specialty Decision-Making Process
Background: There has been an enduring primary care (PC) physician shortage in the United States (U.S.) for decades, which is projected to worsen. With women entering PC at significantly higher rates than men, the aim of this study was to explore various pathways through which gender may affect the medical specialty decision-making process. Methods: Using data from the National Survey of Attitudes and Choices in Medical Education and Training (ACMET) II on a sample of 492 medical residents, this study employed structural equation modeling (SEM) to explore how gender shaped residents’ preferences for future practice and their perceptions of PC, and how their experiences with faculty affected the medical specialty decision-making process. Results: As expected, women were significantly more likely than men to report choosing PC. This study also found that there were several indirect pathways through which gender affects specialty choice, including through negative perceptions about PC and the time spent with PC faculty in medical school. Conclusion: Given the multiple pathways through which gender affects the medical specialty decision-making process, this study highlights a need for gender-specific interventions when addressing the enduring PC physician shortage in the U.S. Specifically, the results of this study suggest that increasing the time that male medical students spend in PC through structural changes in medical education might mitigate negative perceptions about PC and encourage males to enter PC at higher rates. Future research should assess the effectiveness of such gender-specific interventions.
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