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Resident Satisfaction with Continuity Clinic and Career Choice in General Internal Medicine
Lauren A. Peccoralo, MD, MPH1, Sean Tackett, MD3, Lawrence Ward, MD, MPH2, Alex Federman, MD, MPH1, Ira Helenius, MD, MPH4, Colleen Christmas, MD3, and David C. Thomas, MD, MHPE1
1Division of General Internal Medicine, Samuel M. Bronfman Department of Internal Medicine, Mount Sinai School of Medicine, New York, NY, USA; 2Division of Internal Medicine, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA, USA; 3Department of Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA; 4Division of General Internal Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
BACKGROUND: The quality of the continuity clinic experience for internal medicine (IM) residents may influence their choice to enter general internal medicine (GIM), yet few data exist to support this hypothesis. OBJECTIVE: To assess the relationship between IM residents satisfaction with continuity clinic and interest in GIM careers.
DESIGN: Cross-sectional survey assessing satisfaction with elements of continuity clinic and residents' likelihood of career choice in GIM.
PARTICIPANTS: IM residents at three urban medical centers.
MAIN MEASURES: Bivariate and multivariate associations between satisfaction with 32 elements of outpatient clinic in 6 domains (clinical preceptors, educational environment, ancillary staff, time management, administrative, personal experience) and likelihood of considering a GIM career.
KEY RESULTS: Of the 225 (90 %) residents who completed surveys, 48 % planned to enter GIM before beginning their continuity clinic, whereas only 38 % did as a result of continuity clinic. Comparing residents likelihood to enter GIM as a result of clinic to likelihood to enter a career in GIM before clinic showed that 59 % of residents had no difference in likelihood, 28 % reported a lower likelihood as a result of clinic, and 11 % reported higher likelihood as a result of clinic. Most residents were very satisfied or satisfied with all clinic elements. Significantly more residents (p0.002) were likely vs. unlikely to enter GIM if they were very satisfied with faculty mentorship (76 % vs. 53 %), time for appointments (28 % vs. 11 %), number of patients seen (33 % vs. 15 %), personal reward from work (51 % vs. 23 %), relationship with patients (64 % vs. 42 %), and continuity with patients (57 % vs. 33...