Are Michigan State University medical school (MSU-CHM) alumni more likely to practice in the region of their graduate medical education primary care program compared to non-MSU-CHM alumni?

Abstract

BackgroundOver the past 10 years, three new MD schools have been created in the state of Michigan, while the Michigan State University College of Human Medicine (MSU-CHM) has increased their class size to 850 students. The aim of this study was to determine if MSU-CHM alumni who graduate from an MSU-affiliated primary care residency from a single graduate medical education (GME) training program in Michigan are more likely to go on to practice in close proximity to the location of their training program immediately after graduation compared to non MSU-CHM alumni. Changes over time in the proportion of primary care graduates who received fellowship training immediately following residency were also compared between these groups.MethodsA review of historical data was performed for all 2000–2016 primary care (Family Medicine, FM; Internal Medicine, IM; Internal Medicine-Pediatrics, IMP; Pediatrics, Peds) program graduates sponsored by Grand Rapids Medical Education Partners (GRMEP). Study variables included primary care program, gender, age at graduation, fellowship training, practice location immediately after graduation and undergraduate medical education location. Summary statistics were calculated for the data. Comparisons were made using the chi-square test or Fisher’s Exact test when appropriate. Significance was assessed at p < 0.05.ResultsThere were 478 primary care program graduates who went into practice immediately following graduation, 102 of whom also graduated from MSU-CHM. Just over half of the graduates were female and the average age at graduation was 32 years. There were 152 FM, 150 IM, 50 IMP and 126 Peds graduates. Those that graduated from both MSU-CHM and GRMEP were more likely to practice in Michigan immediately after residency training (79.4% vs 52.0%; p < 0.001), as well as within 100 miles of GRMEP (71.6% vs 46.4%; p < 0.001). There were 8% of MSU-CHM primary care graduates who went on to fellowship training from 2000 to 2009, increasing to 34% from 2010 to 2016 (p < 0.001).ConclusionMedical school graduates of MSU-CHM who receive GME training in primary care are more likely to practice medicine within close proximity to their training site than non MSU-CHM graduates. However, plans for fellowship after training may add one caveat to this finding.

Ten years of graduates: A cross-sectional study of the practice location of doctors trained at a socially accountable medical school

“…Our study supported the robust positive association between postgraduate training location and practice region found by previous researchers, with FPs or general practitioners more likely to stay in the same region than other specialists [ 35 – 38 ]. Doctors with a NOSM UG and a NOSM PG showed the strongest association: 92% (128/139) of FPs and 57% (4/7) (non FP) generalist specialists in this UG-PG path practised in northern Ontario (overall: 132/146 = 90%).…”

“…The attractiveness of the hometown region and not just the size of the community in determining where doctors will practise has been previously reported in the literature [ 37 , 38 , 46 , 47 ], though its importance is not always well-recognised. For instance, historically much has been made of the positive association between rural hometown and rural practice, without consideration of whether doctors were returning to practice in other communities in their hometown region.…”

Increasing doctors working in specific rural regions through selection from and training in the same region: national evidence from Australia

“…health workforce. They began in rural medicine in 1990 [1][2][3][4][5][6][7], which involved selecting health students from specific rural regions and training them in the same regions for extended periods, to improve local retention. This was considered more efficient and productive than trying to recruit doctors with no connection to rural medicine and the specific region, to work across the broader scope of skills needed in rural communities [8][9][10][11].…”

Medical School Admissions: Defining the Future of Healthcare Delivery in the United States

“…We propose programmatic evaluation of admission decisions beyond completion of medical school, to include consideration of the number of admitted students that fill key health care system needs 5-10 years after their admission. Some of these outcomes we would propose have been considered in the past, such as the production of primary care physicians at medical schools such as Michigan State University College of Human Medicine (Switzer et al, 2018). However we would argue for a much more data-driven approach based on predictive analytics in medical school admissions.…”