Volunteer physician faculty and the changing face of medicine (original) (raw)
Related papers
Academic Medicine, 2010
Purpose A number of U.S. medical schools started offering formal students-as-teachers (SAT) training programs to assist medical students in their roles as future teachers. The authors report results of a national survey of such programs in the United States. Method In 2008, a 23-item survey was sent to 130 MD-granting U.S. schools. Responses to selective choice questions were quantitatively analyzed. Open-ended questions about benefits and barriers to SAT programs were given qualitative analyses. Results Ninety-nine U.S. schools responded. All used their medical students as teachers, but only 44% offered a formal SAT program. Most (95%) offered formal programs in the senior year. Common teaching strategies included small-group work, lectures, role-playing, and direct observation. Common learning content areas were small-group facilitation, feedback, adult learning principles, and clinical skills teaching. Assessment methods included evaluations from student-learners (72%) and direct observation/videotaping (59%). From the qualitative analysis, benefit themes included development of future physician-educators, enhancement of learning, and teaching assistance for faculty. Obstacles were competition with other educational demands, difficulty in faculty recruitment/retention, and difficulty in convincing others of program value. Conclusions Formal SAT programs exist for 43 of 99 U.S. medical school respondents. Such programs should be instituted in all schools that use their students as teachers. National teaching competencies, best curriculum methods, and best methods to conduct skills reinforcement need to be determined. Finally, the SAT programs' impacts on patient care, on selection decisions of residency directors, and on residents' teaching effectiveness are areas for future research.
Medical education in the United States of America
Medical Teacher, 2012
This article was written to provide a brief history of the medical educational system in the USA, the current educational structure, and the current topics and challenges facing USA medical educators today. The USA is fortunate to have a robust educational system, with over 150 medical schools, thousands of graduate medical education programs, well-accepted standardized examinations throughout training, and many educational research programs. All levels of medical education, from curriculum reform in medical schools and the integration of competencies in graduate medical education, to the maintenance of certification in continuing medical education, have undergone rapid changes since the turn of the millennium. The intent of the changes has been to involve the patient sooner in the educational process, use better educational strategies, link educational processes more closely with educational outcomes, and focus on other skills besides knowledge. However, with the litany of changes have come increased regulation without (as of yet) clear evidence as to which of the changes will result in better physicians. In addition, the USA governmental debt crisis threatens the current educational structure. The next wave of changes in the USA medical system needs to focus on what particular educational strategies result in the best physicians and how to fund the system over the long term.
Benefits and costs to community-based physicians teaching primary care to medical students
Journal of General Internal Medicine, 1998
The purpose of this study was to determine the benefits and costs to community-based primary care physicians teaching medical students in their offices. Survey data were collected from 185 preceptors between 1990 and 1996. Respondents reported increases in their enjoyment of the practice of medicine (82%), time spent reviewing clinical medicine (66%), desire to keep up with recent developments in medicine (49%), and patients’ perception of their stature (44%). However, 61% reported a decrease in the number of patients seen when a student was present. We conclude that despite the costs associated with teaching medical students in their offices, preceptors derived many benefits.
Population Health in the Medical School Curriculum: a Look Across the Country
Medical Science Educator, 2020
Introduction Population health (PH) is an important component of medical school education and is required for physicians to practice effectively. Identifying the number of medical schools teaching population health and the individual curricular components could lead to a better understanding of the current status of population health implementation into medical education. Materials and Methods Between February and March 2019, medical schools in the USA were surveyed about the structure and content of their population health curriculum. Differences were analyzed by school funding and class size. Results Respondents were gathered from 28 (68%) public and 13 (32%) private schools; 27 (66%) schools having fewer than 150 students and 14 (34%) having greater than or equal to 150. Thirty-two schools (78%) had a structured PH curriculum. Seven (22%) only had a dedicated preclinical module and 33 (83%) had a longitudinal curriculum throughout multiple years of school. Many programs utilized flipped classroom models (n = 19, 46%); however, only 8 (20%) utilized standardized patients. Health disparities (100%), community health initiatives (88%), and preventative health guidelines (88%) are among the most commonly taught subjects. Quality improvement was taught by 34 of 41 programs (83%), but only sixteen (39%) schools required students to complete a quality improvement project. Discussion Differences in population health curricula were found between school size and funding. As evidenced by this study, most medical schools recognize the importance of population health by including it in their curriculum and a majority are incorporating the subject longitudinally into multiple years of school.
Academic Medicine, 2013
United States is facing a continuing shortage of primary care physicians. 1,2 Responses to the Graduation Questionnaire of the Association of American Medical Colleges by physicians from 1997 to 2006 show there was an overall decrease in those who chose general internal medicine from 15.7% to 6.7%, from 10.2% to 6.6% in general pediatrics, and from 17.6% to 6.9% in family practice. 3 On the other hand, there was an overall increase in the proportion of physicians who chose internal medicine subspecialties (6.8% to 11.4%) and pediatrics subspecialties (2.2% to 4.4%). 3 Recent trends reveal a major drop in graduating medical students specializing in general internal medicine over the past 15 years. In 1998, approximately 55% of residents specialized in general internal medicine, whereas in 2005, this proportion dropped to 20%. 4,5 This ever-growing shortage of primary care physicians is magnified in rural communities. In 2005, there were 55 primary care physicians for every 100,000 people in rural areas compared with an estimated need for 95 per 100,000. 6,7 Whereas approximately 19% of the U.S. population lives in rural America, only about 11% of physicians practice in rural locations. 8 The shortage of rural family practitioners can be attributed to various factors, some of which include an aging rural population, a retiring medical workforce, and fewer medical students interested in practicing in rural areas. 9 Research conducted by the Health Resources and Services Administration Rural Health Research Centers found that effective recruitment strategies for primary care include focusing on students with rural backgrounds, exposing students to rural areas and issues during medical school, and offering financial incentives to practice and remain in rural areas. It also concluded that older and nontraditional medical students are more likely to practice in rural areas. 10 Obstacles that discourage practicing as a rural primary care provider include lower salaries than in urban areas, cultural isolation in rural areas, lower-quality schools and housing options than more metropolitan areas, and a lack of spousal job opportunities. 5,11 Rabinowitz and colleagues 12 have systematically reviewed the outcomes of comprehensive medical school programs designed to increase the rural physician supply, and developed a model to estimate the impact of their widespread replication. The investigators found six studies that summarized the rural outcomes of medical school programs addressing rural physician supply: the Rural Physician Associate Program (RPAP) of the University of Minnesota; the University of Minnesota Medical
Trends in North American medical education
The Keio Journal of Medicine, 2005
Abstract. Medical education in the United States of America (USA), and worldwide, is increasingly concentrating on the process and outcome of the educational experience. The first efforts to substan-tially improve medical education in the USA resulted in the Flexner Report in the ...