Are We Mortgaging the Medical Profession?

Hughes, Robert; Barker, Dianne C.; Reynolds, Richard C.

doi:10.1056/nejm199108083250606

Cited by 22 publications

(4 citation statements)

References 21 publications

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“…There have been repeated calls to expand federal support-for-service programs and even proposals to create a universal, mandatory service requirement for all newly trained physicians. 2,22,27,[31][32][33][34][35] Plans for such expansions and new initiatives must be mindful of all current types of supportfor-service programs-including federal, state, community, and privately sponsored programs-which collectively field an obligated safety-net workforce more than double that generally recognized based on federal program data alone. If an expansion of federal programs is pursued, it should be coordinated with states' efforts.…”

Section: Commentmentioning

confidence: 99%

“…20 These programs also tend not to formally evaluate themselves or document their successes, as they often lack the funds, expertise, and mandate to do so. 18,20 As a consequence, these state-level programs and their contributions have been hidden from national awareness, omitted from most listings of medical safety-net efforts, 2,[21][22][23][24] and overlooked in national access-to-care policy discussions.…”

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confidence: 99%

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State Scholarship, Loan Forgiveness, and Related Programs

Pathman¹,

Taylor²,

Konrad³

et al. 2000

JAMA

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In 1996, states fielded an obligated primary care workforce comparable in size to the better-known federal programs. These state programs constitute a major portion of the US health care safety net, and their activities should be monitored, coordinated, and evaluated. State programs should not be omitted from listings of safety-net initiatives or overlooked in future plans to further improve health care access. JAMA. 2000;284:2084-2092.

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Section: Commentmentioning

confidence: 99%

mentioning

confidence: 99%

State Scholarship, Loan Forgiveness, and Related Programs

Pathman¹,

Taylor²,

Konrad³

et al. 2000

JAMA

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“…While young physicians are facing increasing obstacles to entering careers in either clinical or biomedical research, including debt (7) and the increasing demands on faculty in clinical departments to generate clinical revenue (8) (which now accounts for 48% of all medical school income [9]), there are special disincentives for entering patient-based investigation. For example, it has been argued that "obtaining funding for human studies is considered so difficult that many investigators are discouraged" (10).…”

Section: Discussionmentioning

confidence: 99%

An organizational model for developing multidisciplinary clinical research in the academic medical center

Charlson

Allegrante

Hollenberg

et al. 1993

Arthritis & Rheumatism

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Objective. To assess the impact of a new organizational model designed to stimulate multidisciplinary clinical research. Results. The multidisciplinary clinical research conference was attended by 369 new health professionals; 218 professionals participated in at least one of the courses; and 280 consultations were provided to 108 professionals. Thirteen new investigators developed 17 new grant proposals, of which 14 were externally funded. Investigators who successfully procured funding for new projects demonstrated significantly more participation in program components compared with those who did not (P < 0.001 overall).Conclusion. Participation in the program was significantly correlated with the development of new prospective patient-based studies. We conclude that our model has the potential to foster such research in other settings.Paralleling the nascent budgetary constraints and increasing calls for control of health expenditures, there has been a growing demand for clinicians to demonstrate that treatments are effective not only in terms of curing or controlling disease, but also in improving the functional status of patients. Concomitantly, there has been an explosion of new knowledge and technology from recent discoveries in the biomed-

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“…As of 2019, the median student debt burden at graduation from medical school was $200,000 (Association of American Medical Colleges 2019), with no guarantee of passing licensure tests, being admitted to residency (Boyle 2020), becoming board-certified in a specialty, or landing a job. Medical student debt burden and its consequences for the individual and society are matters of national importance and debate (Greysen et al 2011;Hughes et al 1991;Jolly 2005;Thomas 2019). COVID-19 has given medical students plenty of time at home to contemplate the cost and value of their education, especially when they have been deprived of a most important feature: interaction with faculty and patients on the wards (Heudebert and Estrada 2018).…”

Section: Value Of Undergraduate Medical Educationmentioning

confidence: 99%

COVID 19: A Cause for Pause in Undergraduate Medical Education and Catalyst for Innovation

Southworth

Gleason

2021

HEC Forum

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As the world held its breath for news surrounding COVID-19 and hunkered down amidst stay-at-home orders, medical students across the U.S. wondered if they would be called to serve on the front lines of the pandemic. Medical school administrators faced the challenge of protecting learners while also minimizing harm to their medical education. This balancing act raised critical questions in medical education as institutions reacted to changing guidelines. COVID-19 has punctuated already contentious areas of medical education and has forced institutions and organizations to take quick action. From the perspectives of a recent medical school graduate and current resident (ES) and a practicing clinician-educator (SHG), we examine the pandemic's impact on undergraduate medical education through an ethical lens. First, we explore the value of medical education, what drives this value, and how COVID-19 may alter it. We next consider student choice and how shifts toward utilitarianism in healthcare during a pandemic may affect learning and career exploration. Then, we inquire how access to technology may impact the experience of medical students from diverse backgrounds and varied institutions during a rapid shift to socially distanced learning. We identify vulnerabilities for students at several phases of the journey: premedical, preclinical, clinical, and preparation for residency. Finally, we address the hidden curriculum of COVID-19, its potential erosion of empathy among current medical students, and possible long-term consequences for future physicians and patients.

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Are We Mortgaging the Medical Profession?

Cited by 22 publications

References 21 publications

State Scholarship, Loan Forgiveness, and Related Programs

State Scholarship, Loan Forgiveness, and Related Programs

An organizational model for developing multidisciplinary clinical research in the academic medical center

COVID 19: A Cause for Pause in Undergraduate Medical Education and Catalyst for Innovation

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