TABLE 1 : Factors that Influence the Decision to Practice Medicine in West Virginia by Medical School Attended ( continued )
Quality of Life n Not at all Slightly Moderately Very Extremely
Travel / service abroad opportunities
370 296 29 29 6 10
MU 46 38 1 2 3 2 WVSOM 34 28 5 1 0 0
WVU 120 97 8 13 0 2 Not WV 170 133 15 13 3 6
Workload 372 124 68 108 51 21 MU 42 18 9 9 5 1
WVSOM 34 8 6 14 6 0 WVU 124 40 23 43 15 3
Not WV 172 58 30 42 25 17 Community Attributes n Not at All Slightly Moderately Very Extremely Ability to make an impact 382 52 35 111 107 77
Connection to religious or spiritual community
Desire to return to community I ' m from
Desire to return to a community similar to where I ' m from
MU 43 4 5 16 11 7 WVSOM 36 3 5 11 12 5
WVU 125 17 9 32 39 28 Not WV 178 28 16 52 45 37
375 255 53 42 19 6
MU 43 27 9 2 4 1 WVSOM 33 20 6 4 3 0
WVU 124 83 16 19 2 4 Not WV 175 125 22 17 10 1
375 213 29 43 54 36
MU 43 13 3 7 12 8 WVSOM 36 13 2 5 7 9
WVU 124 43 16 22 25 18 Not WV 172 144 8 9 10 1
370 178 44 63 53 32
MU 43 13 3 7 12 8 WVSOM 32 13 4 5 4 6
WVU 120 41 11 33 21 14
Not WV 175 111 26 18 16 4
earning potential were most influential to non-WV medical school graduates ( 34.6 %). The availability of loan forgiveness and / or repayment programs was most influential to West Virginia School of Osteopathic
Medicine ( WVSOM ) graduates ( 30.3 %), though most respondents chose “ not at all ” on the influence of both availability of loan forgiveness and / or repayment programs ( 81.0 %) and service obligation scholarships
( 89.9 %). Most respondents reported slight to moderate influence across quality-of-life factors with workload cited as the most influential ( very / extremely , 19.4 %) and travel / service abroad opportunities “ not at all ” ( 80.0 %). Across all respondents , work autonomy ( 36.2 %) and fellow providers at practice site ( 32.4 %) were most influential work environment factors , with opportunity to conduct research cited as “ not at all ” influential ( 64.9 %).
When asked about the desire to return to their home community or community similar to where they are from , more respondents who attended medical school outside of WV responded “ not at all ” influential ( 83.7 %; 63.4 % respectively ) compared to all WV graduate groups ( 33.9 %; 34.4 %). This response is , at least in part , an artifact of the way the question was asked as physicians from out-of-state could not choose to return to their home community and practice in WV . Moreover , more respondents who attended medical school outside of WV responded , “ not at all ” ( 59.7 %) compared to all WV graduate groups ( 11.7 %) when asked to rate the influence of having an established network of friends and family on their decision to practice medicine in WV ( Table 1 ).
RESPONDENT ORIGIN AND MEDICAL TRAJECTORY
Medical School
Fifty percent of the sample completed medical school in WV , 44 % completed medical school somewhere other than WV , and 6 % did not provide a response for medical school attended . Of the 215 participants who reported graduating from one of WV ’ s three medical schools , 46 graduated from the Marshall University Joan C Edwards School of Medicine ( MU ), 36 from WVSOM , and 134 from the WVU School of Medicine ( WVU ).
The percent total of respondents who attended medical school in WV and were from a rural background was higher ( 36.2 %) compared to those who graduated from medical school out-of-state ( 26.3 %). More respondents who attended medical school outside of WV were from an urban background ( n = 144 , 59.3 %) than a rural background ( n = 99 , 40.7 %). More respon-
West Virginia Medical Journal • March 2022 • 45