Recent article on non-traditional older students
Age may only be a marker for maturity. Rural practice demands physicians who can work with people. This means the ability to adjust, balance, lead, follow, and relate at many levels. Some have experiences that help them early in life, others later, some never at all. Some pay attention and learn and adjust, others resist changing and adapting.
Age and maturity may also help students resist the medical school environment that tends to funnel students into subspecialties or research and away from primary care and service to the underserved. The lack of opportunities for service and to see servants in action may retard the development of a serving physician.
AAMC Data on Rural-Interested Seniors from 1995 GQ Survey demonstrated that senior medical students interested in rural practice tended to be older. Data from my study of physicians in practice over 10 years noted that nearly all had met and usually had married their college or high school sweetheart. These seniors also had more kids.
There are other studies, mostly directed toward primary care, such as those by Madison on Service Orientation, but with rural implications. Also the following:
AUTHORS: Xu G; Veloski JJ; Barzansky B
AUTHOR AFFILIATION: Medical Education Division, Center for Research in Medical Education and Health Care, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. xu3@jeflin.tju.edu
SOURCE: Acad Med. 1997 Nov;72(11):1003-7. SECONDARY SOURCE ID: MED/98047019
ABSTRACT: PURPOSE: To examine whether there are differences between older (30+ years) and usual-aged graduates in the factors that influence their decisions to enter primary care.
METHOD: A national survey of primary care physicians was conducted by mail in early 1993.The survey population comprised physicians who had graduated from U.S. allopathic medical schools in 1983 and 1984. The questionnaire consisted of four parts: practice characteristics, 19 variables influencing the physicians' decisions to enter primary care (rated on a scale from 5 = very strong influence to 1 = no influence), the timing of the decision to enter primary care, and demographic and personal information. Data were analyzed through several statistical methods. RESULTS: In all, 355 (22%) older and 1,241 (78%) usual-aged graduates who were practicing in primary care specialties responded. Compared with the usual-aged graduates, the older graduates were more likely to have grown up in rural or inner-city areas, to have obtained a second academic degree, and to have made the decision to enter primary care earlier. The older graduates' decisions to enter primary care had been more influenced by children and familial responsibilities, whereas the usual-aged graduates had been more influenced by internship and residency experiences and by parents and role models before medical school.
CONCLUSION: This study provides empirical evidence to support the notion that nontraditional students (i.e., older ones) are more likely to commit themselves earlier to a career decision and less likely to be influenced by the socialization process during medical school. In this regard, age-specific factors should receive more attention in the analysis of the physician workforce.
MAIN MESH HEADINGS: *Career Choice, Primary Health Care/*MANPOWER, Specialties, Medical/*MANPOWER
ADDITIONAL MESH HEADINGS: Adult, Age Factors, Comparative Study, Decision Support Techniques, Family, Female, Human, Internship and Residency, Male, Mentors, Population Surveillance, Primary Health Care/STATISTICS & NUMER DATA, Questionnaires, Social Responsibility, Socialization, Specialties, Medical/STATISTICS & NUMER DATA, Support, U.S. Gov't, P.H.S., United States