Family Medicine Standards and Constants - There are reasons for optimal distribution and primary care delivery. In fact it is very hard to keep a family physician from becoming a family physician. Research demonstrates a 25% maximum and a 6% minimum FP choice. Those graduating more than 25% or less than 6%, are working hard to do it.
Medical School Expansion 2004 - 2017 - updated version, now over 24,000 expected per year from US sources and 32000 total added each year from all sources in the world, this is over 7000 more than the previous stability for decades
Top Workforce Outcomes Rankings - family medicine leads in Optimal Workforce Outcomes, not much competition
Academic Medicine's Season of Accountability and Social Responsibility - Dr. Butler encourages medical schools to embrace the changes and better distribution of physicians.
The Invisible Faculty, by Joe Hobbs About preceptors and the value of rural visits and advocacy. This article is posted with permission of Family Medicine, published by the Society of Teachers of Family Medicine.
Birth Origins Articles Student choices of medical school, physician specialty, and practice location are related to birth origin factors such as age, gender, ethnicity, income levels, education, and birth location. These are all factors known to admission committees long before the decision for admission. The older, rural born, instate born, and lower income students students least likely to gain admission in allopathic medical schools are 40 - 80% more likely to choose family medicine when admitted and also are more likely to choose key primary care and psychiatry careers involving distribution. These distributional students are being replaced by others that are less likely to distribute, serve the underserved, and understand those most in need of care.
Ranking Medical Schools and FP Residency Programs Rankings for nearly all medical schools for rural, poverty, older students, MCAT scores, family medicine, and other areas.
Maldistribution Cured: Patient is Noncompliant The US has actually cured maldistribution, an 80 year chronic condition created as much by centralization and urbanization of education and medical school resources as anything else. Sadly the US has not chosen to maintain treatment. Breadth in scope is not just important for practicing family physicians, it is important in education and admissions. Breadth and depth together are excellence, but excellence can only be approached with breadth first and maintained, then depth!!!! States with breadth approaches can make progress in a variety of areas.
Pendulum or Vortex Do not believe in pendulums or any sort of return to a more advantaged position without significant effort. Consider a particle moving in a vortex, viewed from the side it looks like a pendular motion, but it is being sucked down with increasing frequency. Viewed from above it moves in a circle, never getting anywhere in a relative sense, but moving faster and faster, until lost from sight. Viewed from below it is not seen, until it suddenly appears and disappears. We have to plug the drain and let the level of primary care rise. It will take admissions changes and health policy to plug the drain, and education and admissions to increase the flow of family medicine likely students.
Physician Workforce Studies The nation can graduate the physicians it most needs with health policy, education and admissions, or both. Both is a much better combination for physician distribution.
Medicine, Education, and Social Status Graphs and tables and stats
Side Effects of Selecting for Family Medicine Selecting for research and subspecialty is easy, just admit higher MCAT students, those from out of state, foreign born, the most urban, the highest income, the most college and professional education levels in parents. Selecting for family medicine and physician distribution is difficult because the students are different, test differently, etc. Rural, older, lower income, and different students are the key to physician distribution. Selecting such students increases choice of family medicine, and also rural practice, psychiatry, and a wide variety of primary care. Selecting for MCAT increases subspecialty in all schools and may increase physician researchers in the elite 22 schools, but not in the 104 schools that graduate 80% of allopathic physicians.
Research By the Ages Admissions for research should be better understood, but is not. Special selections that work on the 22 elite schools do not work on the 104 majority allopathic schools. Admissions of younger students or early admissions may not represent a good expenditure of resources. The major reason to do so may be competition rather than graduation of researchers. Internal recruitment of older students interested in research appears to be a successful method at many schools with some schools better than others in this area. Researcher retention is less than 25%. Schools graduating researchers should not expect that these researchers will provide any useful benefit after researchers have established careers.
"Physicians occupy an unusual spot in the social structure of rural communities. From an economic standpoint, they are successful entrepreneurs, well-paid business people similar to bankers and lawyers. On the other hand, they are also social servants like policemen or teachers, just as essential to the welfare and functioning of the community but paid for through a fee-for-service mechanism outside of local community control. This anomalous status requires some fairly innovative interpersonal and structural relationships to strike a workable balance." Rosenblatt and Moscovice, 1982 more quotes at Best Quotes in RME
Award Recognition
