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T J Cullen

Publications and source records attributed to T J Cullen.

5 recordsLinked to original sources

Comparing the characteristics of schools that produce high percentages and low percentages of primary care physicians.

To examine whether the medical school environment is important in influencing students to choose careers in primary care, the authors in 1991 compared certain characteristics of the environments of schools that produced high percentages of primary care physicians with those of schools that produced low percentages over a five-year period. The authors used the American Medical Association Physician Masterfile to identify the percentage of graduates of each of 121 medical schools for the period 1981-1985 who entered primary care specialties. They then compared the 25 schools that produced low percentages (22-29%) with the 25 schools that produced high percentages (39-56%). The results demonstrate important differences between the two groups of schools in their commitments to primary care education, their research programs, and their clinical environments supporting required clerkships. The authors conclude that a school's educational environment is an important factor in influencing some students to pursue careers in primary care medicine.

Career Choice

Geographic and specialty distributions of WAMI Program participants and nonparticipants.

In an effort to make the geographic distribution of physicians closer to the distribution of the population as a whole, in 1971 the states of Washington, Alaska, Montana, and Idaho established the WAMI Program. In a departure from the Flexnerian model of medical education, the WAMI Program was organized to distribute the components of medical education throughout the region, both at the medical center at the University of Washington School of Medicine and at remote sites. In the present article, the authors describe the results of the first seven years of the program (1975-1981) in terms of the geographic and specialty distribution of the school's graduates before and after the establishment of the program. At the time of the study, 23 percent of the graduates with WAMI Program experience practiced in nonmetropolitan areas as defined by the U.S. Bureau of the Census. Only 13 percent of all U.S. physicians practiced in such areas in 1981, while 24 percent of the U.S. population lived there. In addition, 61 percent of the graduates with program experience were in primary care practice in contrast to 35 percent of all U.S. physicians. If all U.S. physicians behaved as these graduates do, the distribution of U.S. physicians would be reversed, with the proportion of physicians practicing primary care in nonmetropolitan areas being larger than the proportion of the population living in those areas.

Alaska

Evaluating student performance in a decentralized basic science program.

The results of the evaluation of the basic science curriculum in a regionalized medical education program in the states of Washington, Alaska, Montana, and Idaho (WAMI) are presented and discussed. The hypothesis that students taking the first quarter of basic science at universities remote from the Unversity of Washington School of Medicine (UWSM) will be no different in academic performance from those who remain at the UWSM is tested. The variables considered were student performance on (a) common tests in Anatomy/Histology, Biochemistry, Mechanisms of Physiology, and Epidemiology; (b) subsequent course work at the UWSM; and (c) the mini-tests and Part I of the examinations of the National Board of Medical Examiners. The developement of the common tests is described. Analysis of variance indicates that the null hypothesis cannot be rejected at the .05 level.

Alaska

Which medical schools produce rural physicians?

OBJECTIVE: To examine the hypothesis that medical schools vary systematically and predictably in the proportion of their graduates who enter rural practice. DESIGN: The December 1991 version of the American Medical Association Physician Masterfile was used to examine the rural and urban practice locations of physicians who graduated from American medical schools between 1976 and 1985. Selected characteristics of the medical schools--including location, ownership, and funding--were linked to the Physician Masterfile. MAIN OUTCOME MEASURES: The percentage of the graduates from each medical school who were practicing in rural areas in December 1991, disaggregated by physician specialty. RESULTS: Of the practicing graduates from our study, 12.6% were located in rural counties; family physicians were much more likely than members of other specialties to select rural practice, particularly in the smallest and most isolated rural counties. Women were much less likely than men to enter rural practice. Medical schools varied greatly in the percentage of their graduates who entered rural practice, ranging from 41.2% to 2.3% of the graduating classes studied. Twelve medical schools accounted for over one quarter of the physicians entering rural practice in this time period. Four variables were strongly associated with a tendency to produce rural graduates: location in a rural state, public ownership, production of family physicians, and smaller amounts of funding from the National Institutes of Health. DISCUSSION: The organization, location, and mission of medical schools is closely related to the propensity of their graduates to select rural practice. Increasing policy coordination among medical schools and state and federal governmental entities would most effectively address residual problems of rural physician shortages.

Career Choice