Specialty Choice and Practice Location of Physician Alumni of University of California Premedical Postbaccalaureate Programs

Purpose To investigate the longer-term career outcomes, such as specialty choice and practice location, of underrepresented minority and disadvantaged students who finished a University of California postbaccalaureate (UCPB) premedical program. Method The authors compared 303 UCPB alumni from the 1986-1987 to 2001-2002 cohorts who matriculated into medical school and could be matched to the 2008 American Medical Association Physician Masterfile with 586 randomly selected control physicians who graduated from the same medical schools in the same years as the UCPB alumni. Outcome variables included specialty, practice in a Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA), and practice in a California community with high concentrations of African American, Latino, or low-income residents. Results A greater percentage of UCPB alumni (161/303 [53.1%]) than control physicians (235/586 [40.1%]) were in primary care (P<.001). Although there were no differences between the two groups in the percentages of physicians working in HPSAs or MUAs, a greater percentage of UCPB alumni than control physicians working in California practiced in high-poverty communities (31/191 [16.2%] versus 22/252 [8.7%], P<.016), high-Latino communities (35/191 [18.3%] versus 22/252 [8.7%], P<.01), and high-African American communities (57/191 [29.8%] versus 50/252 [19.8%], P<.02). Conclusions UCPB programs have enhanced the number of physicians entering primary care and working in disadvantaged California communities. However, many UCPB alumni practice in disadvantaged communities in California that are not federally designated as HPSAs or MUAs.