Medical School Expansion: Déjà Vu All Over Again?

Mallon, William T.

doi:10.1097/acm.0b013e318159cca6

Cited by 15 publications

(11 citation statements)

References 14 publications

(7 reference statements)

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“…26 Accepting the status quo, however, or simply producing more physicians, is no more likely to be successful tomorrow than in the past. 27 The status quo has resulted in a primary care workforce for children that has grown tremendously without elimination of major variations in primary care supply. As demonstrated by the dramatic variation in local child physician supplies across the United States in the face of robust expansion in the child physician workforce, current calls for expansion in medical schools and lifting of the graduate medical education cap should be viewed critically.…”

Section: Resultsmentioning

confidence: 99%

Geographic Maldistribution of Primary Care for Children

et al. 2011

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OBJECTIVES: This study examines growth in the primary care physician workforce for children and examines the geographic distribution of the workforce. METHODS: National data were used to calculate the local per-capita supply of clinically active general pediatricians and family physicians, measured at the level of primary care service areas. RESULTS: Between 1996 and 2006, the general pediatrician and family physician workforces expanded by 51% and 35%, respectively, whereas the child population increased by only 9%. The 2006 per-capita supply varied by >600% across local primary care markets. Nearly 15 million children (20% of the US child population) lived in local markets with <710 children per child physician (average of 141 child physicians per 100 000 children), whereas another 15 million lived in areas with >4400 children per child physician (average of 22 child physicians per 100 000 children). In addition, almost 1 million children lived in areas with no local child physician. Nearly all 50 states had evidence of similar extremes of physician maldistribution. CONCLUSIONS: Undirected growth of the aggregate child physician workforce has resulted in profound maldistribution of physician resources. Accountability for public funding of physician training should include efforts to develop, to use, and to evaluate policies aimed at reducing disparities in geographic access to primary care physicians for children.

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Section: Resultsmentioning

confidence: 99%

Geographic Maldistribution of Primary Care for Children

et al. 2011

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“…According to Mallon (7): The first two decades of the 21st century may well be viewed by future generations as the second great expansion of post-Flexnerian medical education in the United States … The first era occurred in the 1960s and 1970s, when the number of medical schools accredited by the … LCME increased by half and the number of medical school graduates doubled.…”

mentioning

confidence: 99%

Community-based distributive medical education: Advantaging society

Farnsworth¹,

Frantz

McCune

2012

Medical Education Online

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This paper presents a narrative summary of an increasingly important trend in medical education by addressing the merits of community-based distributive medical education (CBDME). This is a relatively new and compelling model for teaching and training physicians in a manner that may better meet societal needs and expectations. Issues and trends regarding the growing shortage and imbalanced distribution of physicians in the USA are addressed, including the role of international medical graduates. A historical overview of costs and funding sources for medical education is presented, as well as initiatives to increase the training and placement of physicians cost-effectively through new and expanded medical schools, two- and four-year regional or branch campuses and CBDME. Our research confirms that although medical schools have responded to Association of American Medical Colleges calls for higher student enrollment and societal concerns about the distribution and placement of physicians, significant opportunities for improvement remain. Finally, the authors recommend further research be conducted to guide policy on incentives for physicians to locate in underserved communities, and determine the cost-effectiveness of the CBDME model in both the near and long terms.

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“…Ten years later, the need to train more physicians is now recognized, and FSU COM has led the increase in the number of U.S. medical schools from 2000 to 2015 that future generations may call the second great expansion of postFlexnerian medical education. 13 The call by Flexner to return medicine to its roots in science and inquiry reflected the mediocre quality and profit motive of many schools and teachers in his day. 14 The Flexner Report 2 led directly to the long-standing and strongly held view that students must learn clinical medicine primarily from full-time academic faculty on the inpatient services of teaching hospitals.…”

Section: Present Success Future Challengesmentioning

confidence: 98%

Florida State University College of Medicine

et al. 2012

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The Florida State University College of Medicine (FSU COM) was established in 2000, the first new MD-granting medical school in the United States in over 25 years. In its brief history, the FSU COM has developed rapidly in accordance with its founding mission to meet the need for primary care physicians, especially those caring for the elderly and the underserved. The school recently received a full continuation of accreditation for the maximum period, eight years, from the Liaison Committee on Medical Education.The authors describe FSU COM's new, innovative educational program using community-based clinical training on six statewide regional campuses and two rural sites. Third- and fourth-year students are assigned to community physicians in a one-on-one clinical training model in all of the settings where physicians practice. Over 70% of student clinical training is in such settings. The authors describe how the model operates, including curricular oversight (which ensures quality and equivalence of the educational experience at all sites), the regional campus structure, administration, education program delivery during core clerkships, and assessment of students' performance. Ongoing required faculty development for all clerkship faculty is an essential feature of the training program, as is tracking of all individual student contacts through an online clinical data collection system used for evaluation of the clerkship experiences as well as research.The authors demonstrate that the school has been highly successful in implementing its mission, and that the challenge ahead is to sustain its approach to the training of future physicians.

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Medical School Expansion: Déjà Vu All Over Again?

Cited by 15 publications

References 14 publications

Geographic Maldistribution of Primary Care for Children

Geographic Maldistribution of Primary Care for Children

Community-based distributive medical education: Advantaging society

Florida State University College of Medicine

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