Background and Objectives: The Family Medicine for America’s Health Workforce and Education Team aims to increase the number of medical students choosing family medicine to address the projected primary care physician shortage. This aim can be achieved by developing a well-trained primary care workforce. Our student- and resident-led FMAHealth work group aimed to identify factors that influenced fourth-year medical students’ choice to become family physicians. The secondary objective compared such factors between the 10 medical schools with the highest percentage of students matching into family medicine and non-top 10 medical schools. Methods: Fourth-year medical students nationwide participated in 90-minute virtual focus groups. Reviewers coded deidentified transcriptions and identified key themes and subthemes that were found to influence student choice. Results: Fifty-five medical students participated in focus groups over a 2-year period. Three key themes were found to influence students: perspective, choice, and exposure. Subthemes included: (1) the importance of high-quality preceptors practicing full-scope family medicine, (2) the value of a rural experience, and (3) institutional support to pursue family medicine. Physician compensation and loan repayment concerns were not major factors influencing student choice. Conclusions: Many factors influence student choice of family medicine including preceptors, clinical exposures, and institutional support. These factors varied by institution and many were found to be different between top 10 and non-top 10 schools. Addressing these factors will help increase students’ choice of family medicine and reduce the primary care shortage.

Background and Objectives: Fewer than 10% of US medical school graduates enter family medicine residencies each year. Little is known about the perceptions and attitudes of senior medical students as they make final decisions about specialty choice, especially those that support a decision to pursue family medicine. The American Academy of Family Physicians (AAFP) administered a national survey to US seniors in 2015 to explore these factors. Methods: US seniors who were AAFP members (N=11,998) were invited to complete a survey exploring attitudes toward family medicine and experiences that influenced interest and choice of family medicine (FM) or other specialties. This was offered after students submitted their National Residency Matching Program rank list but before match. For those matching in family medicine, additional questions explored mentorship experience. Factors significantly predicting intent to match in family medicine, mentor attributes significantly influencing student attitudes, and family medicine interest group (FMIG) participation were identified via regression. Results: The survey response rate was 15.1%. Student perceptions of the respect of FM (OR=0.82), the future of FM (OR=2.04), and FMIG involvement (OR=1.75) predicted choosing FM, as did AAFP student membership (OR=2.13-2.44) and AAFP National Conference of Family Medicine Residents and Students attendance (OR=9.77). For students entering FM, having supportive mentors outside of FM and being dedicated to FM positively influenced their attitudes toward FM and their FMIG participation. Conclusion: National programs, FMIGs, mentorship, and medical school support of family medicine play a role in student selection of family medicine.

Medical education is undergoing significant transformation. Many medical schools are moving away from the concept of seat time to competency-based education and introducing flexibility in the curriculum that allows individualization. In response to rising student debt and the anticipated physician shortage, 35% of US medical schools are considering the development of accelerated pathways. The roadmap described in this paper is grounded in the experiences of the Consortium of Accelerated Medical Pathway Programs (CAMPP) members in the development, implementation, and evaluation of one type of accelerated pathway: the three-year MD program. Strategies include developing a mission that guides curricular development – meeting regulatory requirements, attaining institutional buy-in and resources necessary to support the programs, including student assessment and mentoring – and program evaluation. Accelerated programs offer opportunities to innovate and integrate a mission benefitting students and the public. Abbreviations: CAMPP: Consortium of accelerated medical pathway programs; GME: Graduate medical education; LCME: Liaison committee on medical education; NRMP: National residency matching program; UME: Undergraduate medical education

When the Family Medicine for America’s Health (FMAHealth) Workforce Education and Development Tactic Team (WEDTT) began its work in December 2014, one of its charges from the FMAHealth Board was to increase family physician production to achieve the diverse primary care workforce the United States needs. The WEDTT created a multilevel interfunctional team to work on this priority initiative that included a focus on student, resident, and early-career physician involvement and leadership development. One major outcome was the adoption of a shared aim, known as 25 x 2030. Through a collaboration of the WEDTT and the eight leading family medicine sponsoring organizations, the 25 x 2030 aim is to increase the percentage of US allopathic and osteopathic medical students choosing family medicine from 12% to 25% by the year 2030. The WEDTT developed a package of change ideas based on its theory of what will drive the achievement of 25 x 2030, which led to specific projects completed by the WEDTT and key collaborators. The WEDTT offered recommendations for the future based on its 3-year effort, including policy efforts to improve the social accountability of US medical schools, strategy centered around younger generations’ desires rather than past experiences, active involvement by students and residents, engagement of early-career physicians as role models, focus on simultaneously building and diversifying the family medicine workforce, and security of the scope future family physicians want to practice. The 25 x 2030 initiative, carried forward by the family medicine organizations, will use collective impact to adopt a truly collaborative approach toward achieving this much needed goal for family medicine.

No abstract