Format

Send to

Choose Destination
See comment in PubMed Commons below
Ann Fam Med. 2016 Sep;14(5):446-52. doi: 10.1370/afm.1971.

Hostility During Training: Historical Roots of Primary Care Disparagement.

Author information

1
School of Medicine, University of Kansas, Kansas City, Kansas jbrooks6@kumc.edu.

Abstract

PURPOSE:

The environment during medical school has been shown to dissuade students from choosing primary care careers. The purpose of this study was (1) to explore how long-standing this hostility toward primary care is historically and (2) to understand the mechanisms through which the environment conveys disparagement of primary care to students.

METHODS:

The study is based on a qualitative analysis of 52 primary care physician oral histories. The data are from the Primary Care Oral History Collection, created by Fitzhugh Mullan and deposited in the National Library of Medicine. Transcripts were analyzed using qualitative data analysis and the constant comparative method.

RESULTS:

Respondents (63.5%) reported experiencing discouragement or disparagement about primary care, and this proportion remained fairly high through 5 decades. Findings indicate that hostility toward primary care operates through the culture and the structure of medical training, creating barriers to the portrayal of primary care as appealing and important. Support for primary care choice was uncommon but was reported by some respondents.

CONCLUSION:

The primary care shortage and primary care's unfavorable representation during medical training is a multifaceted problem. The evidence reported here shows that cultural and structural factors are critical components of the problem, and have existed for decades. For policy responses to be most effective in meeting the primary care workforce problem, they must address the presence and power of persistent hostility against primary care during training.

KEYWORDS:

general practice; hidden curriculum; medical education; medical schools; socialization

PMID:
27621161
PMCID:
PMC5394363
DOI:
10.1370/afm.1971
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Support Center