Background References Conclusions and Future Directions Acknowledgements Results The United States spends more money on healthcare than all other industrialized nations yet the US continues to have relatively poor health outcomes. 1 The AAMC, IOM, and CDC have recommended increased public health training for future physicians at the MPH level or higher. 2 22% of medical school graduates felt their school’s instruction in public health was inadequate 3 Relatively few medical school graduates decide to pursue formal training in public health. The process by which medical students make a decision to pursue formal public health training is not well defined due to multiple factors. We hypothesized that medical students’ decisions to pursue formal public health training would include recurrent themes. We sought to identify the factors involved in medical students’ decisions to pursue dual medical and public health degrees and to describe the decision making process. Methods Discussion Decision Making Model Robin Sautter, MS2; Sarah McFarland, MS3, MPH; Peter Meyers, MS4, MPH; Amanda Honsvall, MS2; Jacob Prunuske, MD, MSPH Department of Family Medicine & Community Health, University of Minnesota Medical School, Duluth, MN Medical Student Decision Making in Pursuit of Public Health Training Phase 1: Focus Group Discussions The purpose of the focus groups was to refine interview questions used during phase 2 of the project. Each focus group was approximately 90 minutes each. Phase 2: One-on-One Telephone Interviews Using convenience sampling, 23 one-on-one telephone interviews were conducted with medical students around the country. Interviews were recorded and open coding and thematic analysis was used for data analysis. 4 Analysis Categories and Themes 1)Motivation for entering a PH program  Gaining knowledge beyond clinical knowledge  Previous work, education and/or volunteering in PH  Gaining the ability to see the “bigger picture” 2) Perceptions of career benefit  Gaining skills (e.g. statistical analysis) and vocabulary  Better understanding/utilizing of community resources  Building perspective on health care systems as a whole 3) Factors considered  Sync with family/partner (pro)  Additional opportunities (pro)  Finances and delaying practice (cons) 4) Decision making process  Helpful to have role models or colleagues with a dual degree  Being pushed by a mentor 5) Resources that could/would increase confidence in decision making  Mentor (physician or peer) to discuss options  Presentation of alternative options to a dual degree “Doctors are often more focused on the problem at hand, and sometimes that’s too narrow for their patients.” The authors would like to thank the University of Minnesota Medical School as well as medical school and public health school staff who helped us connect with their students around the country. A special thanks to Allison Bristow for her data transcription. Iterative decision making process -- Variability in weighing factors -- Some students become “stuck” -- Peer & mentor guidance are significant -- “Gut feelings” influence decision points Decisions on whether to pursue formal PH training are based on consideration of academic, personal, and financial factors. Our findings provide a framework for understanding the decision making process. Mentors may use themes and our model to assist mentees in the decision making process. Future research should explore ways to support medical student decision making and to reduce barriers to PH training. “My interest in public health came from an interest in poverty…I saw medicine as a way to alleviate a symptom of poverty.” 1.Davis K, Schoen C, Stremikis K. Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally, 2010 Update. The Commonwealth Fund; Institute of Medicine (US) Committee on Educating Public Health Professionals for the 21st Century, Gebbie K, Rosenstock L, Hernandez L. Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century. Washington DC: National Academies Press; Association of American Medical Colleges Medical School Graduation Questionnaire All Schools Summary Report. Accessed December 29, Pope C, Mays N. Qualitative research in health care. In: Malden, MA: Blackwell Pub/BMJ Books; 2006.