Primary care specialty selection: Application of a vocational behavior theory

Background and Objectives: This study was designed to determine whether medical school graduates who completed undergraduate degrees in particular college majors were more likely to enter primary care residencies. John L. Holland's theory of vocational personalities and work environments was used to cluster undergraduate disciplines sharing distinctive qualities. These clusters were evaluated to determine if graduates from similar fields were more likely to pursue residencies in family practice, general internal medicine, or general pediatrics. Methods: Students who graduated from US and Puerto Rican medical schools in 1987 were eligible for the study; college majors of 2,661 graduates entering primary care specialties were analyzed. Results: Students completing undergraduate studies in the following majors selected primary care residencies by a twofold difference over the expected frequency: agriculture, black studies, civil engineering, general studies, literature, occupational therapy, and speech. Chi-square tests revealed no differences across Holland types in the frequency with which science and nonscience students selected primary care residencies. Conclusions: Primary care specialties tend to accommodate students from varied academic backgrounds and appear to be tolerant of individuals who have completed undergraduate course work in either bioscientific or biosocial nonscience disciplines.