- Medical students who attended community college were more likely to practice family medicine than those who did not.
- Note that among family medicine residents, over half
Attending community college increased the likelihood that medical school graduates would practice family medicine, a study suggested.
Compared to medical students who did not attend community college, those who attended community college through dual-credit programs in high school, transfer programs, or after graduating from a 4-year university were more likely to pursue family medicine, reported Efrain Talamantes, MD, of the University of California Davis School of Medicine in Sacramento, California, and colleagues.
Odds ratios in those categories were as follows, all relatively to medical graduates who never attended community college.
Overall, 25.9% of 43,382 medical school graduates attended community college, while 8.7% trained in family medicine. Researchers found a higher proportion of female, black or African American, and Latino graduates attended community college. Out of the 3,787 medical school students who trained in family medicine, 12% attended community college through dual-credit programs in high school, 12.7% did so through a transfer program, and 10.9% attended after receiving a bachelor's degree, while 7.7% did not attend community college, the authors wrote in the Annals of Family Medicine.
"Students who attend community colleges tend to come from more diverse backgrounds in terms of socioeconomic, racial, and ethnicity standpoints, and these are students who are missing in general from medical school," Talamantes told MedPage Today. "We have an underrepresentation of Latinos, African Americans, and other underrepresented minority students. [Community college] is not only a source of a more diverse candidate pool, but also a source for students who end up going into primary care."
According to the researchers, this study coincides with national data showing only 9.6% of all U.S. doctor of medicine (MD)-granting medical school graduates train in family medicine. Past reports have additionally shown an association between medical students who attend community college and the intent to practice family medicine, something which could be explained by the fact that premedical community college students likely have stronger community ties, work additional jobs outside of school, and foster a sense of civic duty, the authors said. They found that promoting interests in family medicine at the community college level, therefore, can lead to increasing the diversity and supply of primary care nurturing a workforce that can provide for the disadvantaged.
Researchers collected data from the Association of American Medical Colleges (AAMC) on students who graduated from 2010 to 2012, adjusting for age, sex, race, years in medical school, parental education, and high school region. In order to exclude physicians who switched specialties after one year, researchers used results from students who selected their residency during their second year.
Amanda Kost, MD, of the University of Washington in Seattle, stated in an accompanying editorial that "community college represents an important yet undervalued asset" in promoting health equity by providing a diverse workforce. This starts, she said, with educational equity for those students who do not come from high-income homes.
"These findings suggest that we take a hard look at how we think about medical school admissions and the value we assign community college education versus a traditional 4-year degree," Kost wrote. "Community college should not be a barrier for medical school admission. On the contrary, it should be valued for not only the education it provides, the spaces it builds and offers disadvantaged students, but also for the pipeline it creates for those who otherwise could not apply to medical school."
Talamantes and colleagues said it is unclear whether their findings apply to subspecialties within family medicine, such as pediatrics or internal medicine. However, they said this data would have a negligible impact on the study's results, as only 20 to 25% of primary care physicians pursue internal medicine. Additional limitations include individual factors that were not included in the study such as debt, class ranking, and honors, which may contribute to a student's residency choice. Lastly, the AAMC data did not include osteopathic or non-American Medical College Application medical students.
"Future studies should further explore the mechanism by which community college attendance may influence family medicine residency selection," Talamantes and colleagues concluded. "Students attending community college may face additional socioeconomic disadvantages or participate in unique programs that shape their career interests."
The content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by, HRSA, HHS, or the US government. The authors report no conflicts of interest.