Factors associated with the choice of general medicine as a career among Japanese medical students

Background: In Japan, there is a shortage of young physicians in various specialties; the present situation of general medicine or family medicine (GM/FM) in particular is risky. The factors influencing the career choice of Japanese medical students are poorly understood. This study aims to identify factors related to choosing GM/FM as a career. Methods: The study was designed as a cross-sectional survey. Students at one medical school in Japan filled out a questionnaire. Students were asked to state their intended medical specialty, and they rated the importance of specific individual and occupational aspects using a 4-point likert scale. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach's alpha coefficients; biserial correlations between the factors and career choices were calculated. Furthermore, multiple linear regression analysis was performed using career choice (GM/FM vs. others) as the criterion variable and the factors plus demographic characteristics as confounding variables. Results: Factor analysis produced six factors that explained future career plans. Medical students in this study had a positive and realistic idea about GM/FM, but only 18.8% of them chose GM/FM first as a career. The significant variables associated with choosing GM/FM first as a career were: 'Admission from hometown' (beta = 0.189, P = 0.001), 'Student preparing for the entrance exam' (beta = 0.172; P = 0.001), 'Intent for rural practice' (beta = 0.123, P = 0.016), and 'Work-life balance' (beta = 0.126, P = 0.013). While significant variables that were negatively associated with choosing GM/FM were 'Presence of medical relatives' (beta = -0.107, P = 0.037) and 'Scientific orientation' (beta = -0.125, P = 0.013). Conclusions: Strategies have been suggested, such as recruiting medical students with significant variables that were associated with choosing GM/FM first as a career. By engaging students early in their choice of career, we may be able to increase enthusiasm for this specialty.