Influence of a rural background on a medical student's decision to specialize in family medicine.

INTRODUCTION: Minority populations, including those from rural areas, continue to be underrepresented in medical schools despite increased efforts to recruit them. Although family physicians are more highly represented in rural areas, and medical students from rural areas are more likely to return to rural areas, relatively few medical students enter the specialty of family medicine in the USA. Because family physicians are a smaller proportion of all practicing physicians--both urban and rural--in the east when compared with the remainder of the USA, this study examines the influence of a rural background on career decisions of medical students in an eastern state, New York. New York's social and political structure is additionally influenced by the presence of New York City, the largest city in the USA and one of the world's major financial centers. METHODS: A retrospective, case-control study comparing medical school graduates entering family medicine residencies with those entering residencies in other disciplines was conducted for a period of 16 years at a north-east medical school. The size of the town or city of the student's high school graduation was used to determine which students came from a rural background. RESULTS: Students graduating from rural high schools were more than twice as likely to enter family medicine (OR 2.27, p<0.01) than those from non-rural high schools. CONCLUSIONS: In order to alleviate health disparities and meet health manpower needs, admitting students to medical school who graduated from rural high schools will increase the rural workforce.