Scope of Practice and Family Medicine Match Rates: Results From a CERA Clerkship Directors' Survey.

BACKGROUND AND OBJECTIVES: Family medicine clerkship directors depend on community preceptors to teach and attract medical students to family medicine. Many community preceptors do not provide the full range of family medicine services, and some are not family physicians. This study aimed to determine the types of practices in which family medicine clerkship students train and whether scope of practice is associated with family medicine Match rates.

METHODS: Data were collected as part of the 2014 Council of Academic Family Medicine Educational Research Alliance (CERA) Family Medicine Clerkship Director Survey. Clerkship directors estimated the percentage of their preceptor sites providing each of nine clinical services and the percentage of students placed with internal medicine physicians for their family medicine rotations. We devised a Scope of Practice Index (SPI) to assess scope of practice and measured the association between a clerkship's SPI and family medicine Match rate.

RESULTS: Limited scopes of practice were common. SPI was lowest in the Northeast and highest in the West. In bivariate and multivariable analyses, a lower SPI was associated with lower family medicine Match rates. Preventive gynecological care was the service most highly associated with family medicine Match rates. Family medicine Match rates were lower when programs used internal medicine sites for their family medicine rotations.

CONCLUSIONS: Many clerkship students are exposed to practices with limited scopes of family medicine practice, and this is associated with lower family medicine Match rates. These findings have implications for the specialty as preceptor scope of practice declines.