Different types of medical students and different career choices are more likely to be found at different practice locations. These are studies of physician birth origins compared to practice locations. Instate birth
Instate Born and Rural Practice
Odds Ratios Using 5 Different Logistic Regressions
|
|
Major Medical Center |
Underserved |
Urban Underserved |
Rural Not Major Med Center |
Rural Underserved |
|
% of physicians at location |
77% |
5.3% |
3.0% |
7.5% |
2.3% |
|
Family Medicine |
0.267 |
2.738 |
1.95 |
3.917 |
3.63 |
|
Rural Instate Born |
0.736 |
1.094 |
0.7 |
1.927 |
1.46 |
|
Bottom Income Quartile Birth |
0.851 |
1.776 |
1.39 |
1.292 |
1.99 |
|
Older than 29 at grad |
0.779 |
1.396 |
1.21 |
1.403 |
1.505 |
|
Younger than 26 at grad |
1.045 |
0.862 |
0.85 |
0.804 |
0.884 |
|
Med School County/City |
1.145 |
0.879 |
0.96 |
0.712 |
0.772 |
|
Foreign Born |
1.019 |
1.183 |
1.39 |
0.642 |
0.852 |
|
MCAT Top 20 Med School |
1.524 |
0.659 |
0.75 |
0.537 |
0.532 |
Major medical center location choices are most likely for top ranking medical school graduates and those closely connected to medical schools by birth. Lower status origins and older age graduates are less likely to have major medical center location. Family physicians avoid major medical centers.
Underserved locations are more likely for those of lower status origins and older age at graduation. Family medicine choice nearly triples underserved location and doubles urban underserved location. Foreign born contributions are important for the urban underserved component, but not rural.
Rural locations outside of major medical centers are dominated by family medicine with 4 times probability, rural birth at 2 times, lower income origins, and older age.
Those with connections to rural areas, instate connections, older age at graduation, and birth in the United States have greater rural distributions. Top status students, the youngest medical school graduates, and those most connected to medical schools by birth are less likely to be found in rural areas.
Changes in Admissions in Allopathic Medical Schools