PubMed · 3466398
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T Golabek. 1986. Working for your Uncle (Sam).. https://pubmed.ncbi.nlm.nih.gov/3466398/
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Many policymakers and researchers agree that there are problems of physician oversupply and imbalance in specialty mix. Some have argued that these will be resolved as a more competitive health care market develops, predicting that cost-conscious integrated systems will change demands for physician's services. As a result, physicians will experience unemployment or lower incomes, sending a signal to students and educators to change behavior. Although anecdotes abound, there has been no systematic assessment of what changes in the organization and financing of health care are actually doing to the physician labor market. This article considers potential indicators of changes and reviews what these indicators are now showing. Two types of change are assessed: whether increasing demand for generalists is changing specialty mix, and whether the market is creating incentives to train fewer physicians overall. There have been some changes in the market, but it is still too early to know whether they signal a departure from previous trends. Positions in generalist fields are becoming somewhat more attractive, but changes in incomes have been modest and the number of specialists continues to increase. There is also little indication that job opportunities for physicians are contracting.
The Outreach Center for Science and Health Career Opportunities opened at the University of Kentucky Medical Center in July 1993, to provide a central site of coordination for the university's science education activities designed to link those "doing science" at the medical center with students, teachers, and the general population throughout Kentucky. By providing an infrastructure for outreach programs and by being highly visible to the public, the center attracts extramural funding, allows tracking of the program's students, and facilitates the development of science education partnerships between the university of Kentucky communities. The rationale for establishing the center, methods of operation, and impact on the region's science literacy problem are discussed.
A large body of research on medical students' choice of primary care specialties has been published. However, the literature is difficult to interpret because of multiple biases, design weaknesses, small numbers of subjects, inconsistencies in both dependent and independent variables, and conflicting results. These weaknesses have been noted by authors who have reviewed the work in this area, but the authors have given little direction for ways to improve and build upon the current state of the literature. This paper provides a quantitative description of the content of the specialty choice literature. As part of a larger project that included an exhaustive literature analysis, all research on primary care specialty choice published between 1987 and 1993 was collected and summarized according to study questions, designs, data sources, samples, theory, and outcome variables. Portions of this information were used to rate the quality of each study, yielding a score from zero to 100 that indicated the trustworthiness of the study's conclusions. Overall, the studies examined were found to use predominantly cross-sectional designs and to lack theoretical basis. Special curricular tracks, student personality, and self-reported influences were the most frequently studied determinants of primary care specialty choices. The results confirm previous qualitative descriptions of the state of the literature on specialty choice, and lead to recommendations for approaches to improve the quality of further work in this area. The research agenda that emerged from the larger project is also presented.