I thought I'd pass along an article found by the husband of one of my fellow classmates, Marla (who is also going into Family Medicine), and which was forwarded to me. I'm not sure exactly where it was published-- sorry.
Why don't other people want to go into such a fabulous field? :) At least I can have some sense of job security if there are too few primary care practitioners to treat everybody.
Slump in Family-Medicine Residencies Raises Concern as Medical Students Get Match Day Assignments
By KATHERINE MANGAN
In medical schools across the country, thousands of students tore open envelopes on Thursday to find out where they will spend the next several years training to be doctors. General surgery and obstetrics and gynecology were hot; family medicine was not, and that has educators worried.
For the ninth year in a row, the number of family-medicine residency positions offered through the match dropped. And even though the percentage of slots that were filled was up slightly this year, fewer than half of them were taken by seniors in American medical schools. The rest went to graduates of foreign and osteopathic schools and other applicants.
The continued slump has medical educators concerned that there won't be enough physicians to treat an aging population with a higher prevalence of chronic diseases (The Chronicle, January 12).
"Family physicians are the nexus of the U.S. health-care safety net," Rick Kellerman, president of the American Academy of Family Physicians, said in a written statement on Thursday.
"Unless purposeful steps are taken now, the continuing low proportion of medical students choosing family medicine will mean an increasingly fragmented, overspecialized, inefficient system. This spells problems for all generations of people in all communities, from urban and suburban to rural and frontier America."
In an interview, Dr. Kellerman said the nation will need 40,000 more family physicians by the year 2020, "and we can't do that when fewer than 8 percent of U.S. medical-school graduates go into family medicine." Medical-school graduates with debts of $100,000 or more are increasingly drawn to higher-paying specialties, especially when those positions require fewer hours on the job.
"Our medical-school graduation rates are going one way, and the needs of society are going the other way," Dr. Kellerman said.
The number of family-medicine residency positions offered -- 2,603 this year -- has dropped each year since 1998, when 3,292 positions were available, according to figures provided by the National Resident Matching Program. In some cases, hospitals that have had trouble filling residency programs have had to drop them.
The residency program is sponsored by several medical groups, including the American Hospital Association, the American Medical Association, and the Association of American Medical Colleges.
Other primary-care specialties also took a hit this year. Just 15 percent of this year's applicants for residency positions selected clearly identified primary-care programs in pediatrics, internal medicine or family medicine.
Over all, a record number of students (27,944) applied for a record number of residency positions (21,845) this year. (See chart.) Of those students, 15,206 were seniors in American allopathic medical schools. (Allopathic schools offer M.D. degrees; osteopathic schools, which describe themselves as emphasizing holistic treatment, offer D.O. degrees.)
The pool also included 6,992 graduates of foreign medical schools, a 9 percent jump over last year.
Most applicants walked away happy. Ninety-three percent of the seniors who applied for residency positions were matched, and 84 percent of the matched students ended up in one of their top three choices.
Participants in the match choose a specialty and submit their top choices for residency programs within that specialty, ranked in order of preference. Meanwhile, residency-program directors and their committees decide which applicants they'd like to have in their programs and submit a rank order of those applicants. The match uses a computer algorithm to align the preferences of the applicants with those of the residency programs.
Across the country, it has been a nail-biting week for medical students, who found out on Monday whether they had been matched, and, on Thursday, which programs they had matched with.
Julia Wilkinson is a fifth-generation Louisianan who was thrilled to end up in a general-surgery residency program at Louisiana State University Health Sciences Center -- her top choice and the same place where she's attending medical school. She and her classmates crowded into a gymnasium on Thursday and opened their envelopes, as the names of the students and their residency programs flashed on a large screen in front of the room.
"I opened my envelope with my mom and dad and younger brother, and there were high-fives all around," she said. "I'm really excited about remaining here and being part of the rebuilding."
The New Orleans-based health-care program fared well in the match. "We had been very concerned about the match because of the conditions in New Orleans, and the condition of the hospitals," said Larry H. Hollier, chancellor of the Health Sciences Center and dean of medicine at LSU (The Chronicle, October 27, 2006).
Despite those concerns, "we did extremely well," Dr. Hollier said. Ninety-three percent of the center's residency positions were filled in the initial match, and 100 percent were filled by the next day, when unmatched residents scrambled to fill unmatched residency slots.
The University of Toledo, however, is worried that its medical students aren't sticking around. Only 12 of its 150 medical seniors matched with residency programs in northwestern Ohio. That, combined with the region's aging physician work force, could lead to a physician shortage "of crisis proportions" unless area residency programs are beefed up, a blue-ribbon panel has concluded.
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The following article tells about an exciting new program designed to attract new students to family medicine.
The Lake Erie College of Osteopathic Medicine (LECOM) is taking a lead position in the future of medical education by introducing a new program to attract more physicians to family practice. LECOM is continuing its mission to help grow the osteopathic medical profession by starting a Primary Care Scholars Pathway (PCSP) that will reduce the time it takes to become a family physician.
The LECOM PCSP has received approval from the American Osteopathic Association Committee on Osteopathic College Accreditation and backing of the American College of Osteopathic Family Practice.
The PCSP will condense four years of medical education into three years in order to graduate more family doctors sooner and to save these students one year of expenses that adds to the mounting debt held by medical college graduates.
“LECOM proposed this innovative curricular pathway in response to the declining interest in primary care and particularly family practice,” explained LECOM President John M. Ferretti, D.O. “We hope to attract new students by offering them a shorter path to a medical degree without jeopardizing their education in the areas needed to train a family physician.”
LECOM formed a committee through the College’s Primary Care Department led by Associate Professor of Family Medicine Richard Ortoski, D.O. The committee reviewed the need for family physicians and the factors causing the decreasing number of medical students who are interested in primary care.
“Numerous factors account for the declining numbers of medical students applying to become family doctors,” according to Hershey Bell, M.D., Director of the LECOM Teaching and Learning Center and a member of the PCSP committee. “The rising cost of medical education and the lower earning power of family practice physicians becomes an impediment to students with an interest in family medicine.”
Research indicates that medical college selection factors based on higher MCAT scores and GPAs weigh against students who want to become family physicians in rural areas and small towns where the need for new doctors is greatest. LECOM plans to carefully select applicants who show the greatest interest in family practice and who have the best chance to succeed.
The committee looked at the best ways to meet the educational requirements and keep the curriculum within four years.
Based on LECOM’s experience developing its unique Problem-Based Learning and Independent Study curriculums, the committee chose to use the Independent Study learning modules as a guide to the new curriculum.
“Medical education has moved toward teaching seven core competencies of osteopathic medicine,” according to Silvia M. Ferretti, D.O., LECOM Provost/Vice President and Dean of Academic Affairs. “Our curriculum will emphasize those competencies including professionalism, medical knowledge, and patient care so we can prepare our graduates to provide quality health care when they graduate.”
LECOM will eliminate the student’s first summer vacation and start the second year basic science and clinical courses so that the second year will end in early March. PCSP students immediately will begin core clinical rotations at carefully selected hospitals and physician offices. The college will designate Millcreek Community Hospital, St. Vincent Health Center, and Hamot Medical Center in Erie, PA, along with Meadville (PA) Medical Center and UHHS-Richmond Heights, OH, as the core rotation sites for PCSP students.
Dr. Ortoski’s group also reviewed the third-year and fourth-year clinical rotations needed to become family physicians. “We see in every medical school class that students choose electives based on their desire to explore medical specialties and audition for internships and residencies at their favorite hospitals while on rotations,” Dr. Ortoski explains. “By concentrating on the core primary care rotations and creating new clinical experiences needed to become good family doctors, we can reduce the final two years of medical college to just over a year.” With less vacation time, PSCP students still will have spent as much time in training as their fellow students in the four-year programs.
In the fall of 2007, LECOM will select its first PCSP class from a group of candidates after they complete the first twelve weeks of Gross Anatomy. Medical students who enter PCSP in October 2007 will graduate with a Doctor of Osteopathic Degree in 2010. Graduates will continue their post-graduate education through a three-year residency program at selected hospitals.
The AOA COCA approved the substantive change requested by LECOM to initiate the Primary Care Scholars Pathway in the 2007-2008 academic year. The program will begin with six students in the first year, eight in 2008-2009, 10 in 2010-2011, and 12 students in 2011-2012. The new program will not affect the approved class size, which the AOA has set at 250 students in 2007.
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The Lake Erie College of Osteopathic Medicine is one of the fastest growing medical schools in the country. LECOM has medical colleges in Erie, Pennsylvania and Bradenton, Florida and a School of Pharmacy in Erie.
A Doctor of Osteopathic Medicine (D.O.) is a physician trained and licensed to practice the full scope of medicine in all 50 states. D.O.s focus on the whole person and consider all facets of a person's life when treating illness, disease and injury. In addition to using all forms of standard medical treatment, D.O.s are trained to use osteopathic manipulative treatment to help diagnose injury and illness, to alleviate pain and to promote wellness. Osteopathic physicians work in partnership with each person to help promote health on physical, emotional and spiritual levels.
The Doctor of Pharmacy has become a key partner in primary health care and complements LECOM’s osteopathic, whole-person medical mission.
The demand for pharmacists is high due to the increased medication and health care needs of an older population. There are also a wide variety of practice settings for our graduates to choose from including, community, hospital, industry, mail service/internet, managed care, government, academia, and others.
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