Trends in US Medical School Contributions to the Family Physician Workforce: 2018 Update From the American Academy of Family Physicians

Phillips, Julie; Wendling, Andrea; Bentley, Ashley; Marsee, Rae; Morley, Christopher P.

doi:10.22454/fammed.2019.395617

Cited by 34 publications

(37 citation statements)

References 12 publications

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“…An important distinction of this impact in the contemporary context is that less than 10% of US allopathic medical students currently enter family medicine residency training. 30 MSU-CHM's Rural Physician Program, which includes a mission-fit selection process and substantial clinical training in a rural region, 19 is one such successful model.…”

Section: Original Articlesmentioning

confidence: 99%

Trends in Subspecialization: A Comparative Analysis of Rural and Urban Clinical Education

Wendling

Short

Hetzel

et al. 2020

Fam Med

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Background and Objectives: Medical students who train in rural communities are often exposed to physicians practicing a broad scope of care, regardless of discipline. We examined how rural education is associated with practice specialization rates for students who match in primary care or general core specialties. Methods: We linked practice and specialty data (2016 AMA Masterfile dataset), demographics (American Medical College Application Service data), and internal college data for 1974-2011 Michigan State University College of Human Medicine graduates who received clinical education on either the Upper Peninsula (rural) or Grand Rapids (urban) campuses. Current practice was verified using internet searches. We compared specialty and practice data by rural or urban campus, controlling for multiple variables. Results: More rurally-trained graduates entered primary care (PC) residencies (128/208, 61.5%) than urban-trained graduates (457/891, 51.3%; P<.01), with rurally-trained graduates being twice as likely to enter family medicine (FM) residencies. Most FM residents remained PC physicians (205/219, 93.6%). Internal medicine residents were least likely to remain in primary care (91/189, 48.1%). Of the general core disciplines, general surgeons were least likely to remain in general surgical practice (45/134, 33.6%). Within each PC or general core discipline, the proportion of graduates who specialized did not differ by type of campus. Conclusions: Rurally-trained graduates are more likely to practice primary care, chiefly due to increased likelihood of choosing a FM residency. Graduates entering PC or general core residencies subspecialize at similar rates regardless of rural or urban education. FM residency match rate may be the best predictor of long-lasting impact on the primary care workforce.

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Section: Original Articlesmentioning

confidence: 99%

Trends in Subspecialization: A Comparative Analysis of Rural and Urban Clinical Education

Wendling

Short

Hetzel

et al. 2020

Fam Med

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“…The looming rural health crisis, especially for older adults, due to lack of access to oral health care, together with the declining number of healthcare physicians in rural and underserved areas, could be avoided or minimized by graduating dental physicians. 15,16…”

Section: Need For Integration Of Oral and Systemic Health Carementioning

confidence: 99%

Should dentistry be a specialty of medicine? Two viewpoints

Akyalçın

Bruzzaniti

Chávez

et al. 2020

Journal of Dental Education

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Dentistry and dental education are well‐established domains with deep‐rooted institutions, educational programs, organizational structures, and advanced specialty fields. Almost 100 years ago, Dr. William Gies, founder of the Columbia University College of Dental Medicine, stated that to best serve the oral health needs of the population, dentistry should be considered a specialty of medicine, and dental students should have the same solid foundation in the basic and clinical sciences as medical students. More recently, the report on “Advancing Dental Education in the 21st Century” recommends an increase in the integration of dental and medical education as a means to address 2 of its key challenges: “shrinking demand for dental services” and “shifting practice environment.” However, it has also been argued that making dentistry and dental education a subspecialty of medicine and medical education will create logistical, structural, regulatory, and financial dilemmas. Instead of a drastic change to current dental educational, organizational, and institutional models, some argue a contemporary approach to dental education is required to ensure dentists are well prepared to address the healthcare needs of the population and future healthcare delivery systems and practice models. Recognizing the need for change in dental education to keep pace with changes in patient demographics and healthcare systems, the dental profession has the responsibility and opportunity to develop new models and paradigms that improve educational and clinical outcomes in our educational programs and future practice.

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“…The U.S. already have many boardcerti ed family physicians. In 2017, 12.6% of medical school graduates entered a family medicine training program, and over the last decade the number of the residents has increased [9]. Thus, in the U.S., family medicine is accepted as a part of healthcare system.…”

Section: Introductionmentioning

confidence: 99%

Geographic Distribution of Family Physicians in Japan and the United States: A Cross-sectional International Comparative Study

Okazaki¹,

Yoshida

Kashima

et al. 2020

Preprint

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Background: Family physicians are known to distribute more equally among the population than other physicians. The maturity of family medicine, i.e. the length of its history as a part of healthcare system and the population of qualified family medicine experts, may affect the distribution, but this has not been shown in the literature. This study compares the geographic distribution of family physicians in Japan and the United States (U.S.), both of which are developed countries without a physician allocation system by the public sector, but the two countries differ greatly in the maturity of family medicine as a clinical specialty.Methods: This is a cross-sectional international comparative study using publicly available online database on the number of physicians in Japan (Board-certification Database of Japan Primary Care Association, and Survey of Physicians, Dentists and Pharmacists by Ministry of Health, Labour and Welfare) and the U.S. (Area Resource File by Health Resources and Services Administration). The municipalities in Japan and counties in the U.S. were divided into quintile groups according to population density. The number of family physicians per unit population in each group of areas was calculated. The geographic distribution of all physicians in Japan was simulated assuming that the proportion of family physicians among all physicians in Japan (0.16%) was increased to that in the U.S (11.8%).Results: The distribution of family physicians in Japan noticeably shifted to the areas with the lowest population density. In contrast, family physicians in the U.S. distributed equally across areas. The distribution of physicians with other specialties (general internists, pediatricians, surgeons and obstetricians/gynecologists) shifted heavily to the areas with highest population density in both countries. The simulation analysis showed the geographic maldistribution of all physicians improved substantially if the proportion of family physicians in Japan increases to that in the U.S. Conclusion: The distribution of family physicians is more equal than other medical specialists, and the immaturity of family medicine can even lead to a rural-biased distribution. In a country with emerging family medicine such as Japan, increasing the number of family physicians may effectively mitigate the urban-rural imbalance of physician supply.

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Trends in US Medical School Contributions to the Family Physician Workforce: 2018 Update From the American Academy of Family Physicians

Cited by 34 publications

References 12 publications

Trends in Subspecialization: A Comparative Analysis of Rural and Urban Clinical Education

Trends in Subspecialization: A Comparative Analysis of Rural and Urban Clinical Education

Should dentistry be a specialty of medicine? Two viewpoints

Geographic Distribution of Family Physicians in Japan and the United States: A Cross-sectional International Comparative Study

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