The Relationship Between Medical School Clerkships and Primary Care Specialty Choice: A Narrative Review

BACKGROUND AND OBJECTIVES: There is a persistent shortage of prima-ry care physicians in the United States. Medical schools can help meet soci-etal primary care health needs by graduating more students who select family medicine and other primary care careers. The objective of this narrative re-view was to evaluate the relationship between clerkships and primary care specialty choice. METHODS: We conducted a systematic literature search and narrative review of research articles examining the association between clerkships and prima-ry care specialty choice. We evaluated the quality of included articles using a validated scale, assessed for methodology and outcomes, and synthesized us-ing a narrative approach. RESULTS: We identified 59 articles meeting our research criteria. A required primary care clerkship in the core clerkship year was associated with increased primary care specialty choice. This finding was strongest for family medicine clerkships and family medicine specialty choice. Clerkships that were longer, were of higher quality, exposed students to a wider scope of primary care prac-tice, and occurred within an institutional climate supportive of primary care were also correlated with more students choosing a primary care specialty. While student self-reported interest in primary care often increased following a primary care clerkship, this interest was not always sustained or consistently associated with a primary care residency match or primary care career. CONCLUSIONS: Required family medicine and primary care clerkships were correlated with primary care specialty choice. More high-quality research is needed to better understand how to maximize the impact of clerkships on pri -mar y care specialty choice.