Evolution of the Family Medicine Clerkship: A CERA Secondary Analysis.

Abstract

Background and objectives: The family medicine clerkship has been found to influence medical students' decision-making regarding specialty choice. Understanding how the family medicine clerkship has changed over the past decade may assist in recruitment efforts. Our study explored trends in family medicine clerkship design, length, and format and correlated these characteristics with high proportions of medical school graduates choosing family medicine.

Methods: We performed a secondary analysis of the Council of Academic Family Medicine Educational Research Alliance annual family medicine clerkship director surveys from 2012 to 2023. We analyzed standard family medicine clerkship structure questions that were asked in each survey. We analyzed trends using Pearson's correlation coefficient test and correlations with χ2 test for independence.

Results: Over the past 10 years, a transition from traditional block-style clerkships toward longitudinal-style clerkships has been increasing. Both block-style and longitudinal-style clerkships have decreased in length, with most clerkships lasting 4 weeks or less. A change also has taken place in the composition of clinical experiences, with reduced use of community preceptors as the primary source of clinical experiences. In 2021, schools with a higher percentage of students working with community preceptors were associated with higher percentages of medical students choosing to pursue family medicine.

Conclusions: Alterations in the family medicine clerkships have led to medical students getting decreased and intermittent exposure to family medicine. Most clerkship experiences are not with community preceptors, a major change following the COVID-19 pandemic. The repercussions of recent changes to the family medicine clerkship on the rate of matching medical students into family medicine remains unclear.