Tamara Oser, MD, Penn State College of Medicine

The US primary care shortage is large and expected to worsen. The American College of Physicians has estimated a 35,000 to 44,000 primary care physician shortage for American adults by 2020, and the Association of American Medical Colleges estimates that by 2020 the country will need 45,000 more primary care doctors due to health care reform.¹ The Council on Graduate Medical Education focused its 20th report on advancing primary care, advising medical schools to create educational environments that foster a physician workforce of at least 40% devoted to primary care.² However, at Penn State College of Medicine, we saw declining numbers of students matching in family medicine from 2005–2011, despite a very active Family Medicine Interest Group, a large number of family medicine faculty participating in curricular elements such as the Clinical Skills and Advising program, and a third-year Family Medicine Clerkship rated particularly highly compared to other clerkships.

In attempting to increase student interest in family medicine, we developed several initiatives to increase student exposure to the diversity of careers available in family medicine.

We designed a brochure for distribution at all Family Medicine Interest Group events and at the beginning of the third-year Family Medicine Clerkship. (Figure 1.) This brochure highlights not only the wide array of career possibilities available within family medicine—many unknown to students—but also specific faculty that students can contact to learn more about these areas.

Roundtable Dinners were designed and implemented to allow small groups of students to meet with family medicine faculty in an informal setting, to ask questions, address misconceptions, and explore the personal side of family medicine, all without fear of evaluation such as they might face on a clerkship. Anonymous, voluntary surveys were distributed to gauge the events’ impact on students’ interest in family medicine. In all cases, interest increased. The greatest observed difference was an increase in the number of students stating they were “very interested” in a family medicine career after the event compared to before. After the events, no student reported being disinterested in family medicine.

Student comments were all positive; representative examples include:

• “The dinner helped me to look at past misconceptions about family medicine and see that there really is much opportunity in this field.”
• “Hearing the life stories and paths of two doctors and how they got where they are was amazing. I really began to understand the variety of opportunities in family medicine.”

All Roundtable Dinner faculty responded that they were likely to participate again, despite the fact that faculty provided dinner at their own expense, suggesting that these dinners were valued by faculty as well.

A Leading the Way for Women in Family Medicine event was also designed. Multiple simultaneous roundtable dinners were held in a larger room, with one or two family medicine faculty at each table of students, followed by a panel discussion. This event was designed not only to highlight the diverse options of a career in family medicine but also to address unique aspects of being a female family physician. Anonymous, voluntary surveys were distributed to gauge the event’s impact on student interest in family medicine. Once again there was an increase in interest reported by all students, with the majority stating they were “very interested” after attending the event. Again, all student comments were positive. Representative examples include:

• “I liked seeing various directions and career paths family medicine can take a person.”
• “Inspiring.”
• “This event confirmed my decision to go into family medicine.”

We know that these events increased student interest in family medicine in the short term. In addition, 12.3% of students matched in family medicine in 2012, 10.9% in 2013, and 10.8% in 2014, all higher than before these initiatives (7.3% the year the events were initiated). Clearly, causality cannot be determined, but we hope that these and future initiatives targeting exposure and mentoring of students in family medicine will help address the primary care shortage.

References

1. Association of American Medical Colleges. AAMC Statement on the Physician Workforce. June 2006. http://www.aamc.org/workforce/workforceposition.pdf.
2. Council on Graduate Medical Education. Advancing primary care. Twentieth report. December 2010.