Career Plans of New Pediatricians: Results from a Survey of Residency Program Directors

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 861-866
Author(s):  
Sarah E. Brotherton
Keyword(s):  
United States ◽  
Academic Staff ◽  
Health Maintenance Organization ◽  
Program Directors ◽  
The United States ◽  
Subspecialty Training ◽  
Pediatric Practice ◽  
Health Maintenance ◽  
Pediatric Residency ◽  
Residency Program Directors

Directors of pediatric residency programs in the United States, Puerto Rico, and Canada were surveyed regarding plans of graduating residents to determine whether new pediatricians experienced problems finding employment in light of a decreasing growth rate in the child population. Nearly 90% of directors responded, providing information on 1915 residents. Of the 1782 nonmilitary residents in the United States, 815 were entering general pediatric practice and one third (596) were entering subspecialty training. Nearly one half (379) of residents entering general pediatric practice were joining a small group practice, almost one fourth (184) were joining a larger group, 6% (48) were becoming solo practitioners, 7% (57) were joining a health maintenance organization, and nearly 8% (62) were joining a hospital or academic staff. Most residents in the United States experienced no difficulty finding a position and received multiple offers for jobs. Canadian residents were similar to residents in the United States, whereas the postresidency situations of graduates of military and Puerto Rican programs were very different. Despite manpower predictions to the contrary, comments by program directors indicated a demand for general pediatricians. This paper presents only the viewpoint of program directors; whether this perceived need illustrates an avid market for young general pediatricians merits further study.

A Model to Determine Workforce Needs for Endocrinologists in the United States Until 20201

2003 ◽  
Vol 88 (5) ◽  
pp. 1979-1987 ◽  
Author(s):  
Robert A. Rizza ◽  
Robert A. Vigersky ◽  
Helena W. Rodbard ◽  
Paul W. Ladenson ◽  
William F. Young Jr. ◽  
...  
Keyword(s):  
United States ◽  
Supply And Demand ◽  
Health Maintenance Organization ◽  
The United States ◽  
Endocrine Disorders ◽  
Office Visits ◽  
Health Maintenance ◽  
Age Related ◽  
Wide Range ◽  
Workforce Needs

The objective of this study was to define the workforce needs for the specialty of endocrinology, diabetes, and metabolism in the United States between 1999 and 2020. An interactive model of factors likely to influence the balance between the supply and demand of endocrinologists during the next 20 yr was constructed. The model used data from a wide range of sources and was developed under the guidance of a panel of experts derived from sponsoring organizations of endocrinologists. We determined current and projected numbers and demographics of endocrinologists in the United States workforce and the anticipated balance between supply and demand from 1999 to 2020. There were 3,623 adult endocrinologists in the workforce in 1999, of which 2,389 (66%) were in office-based practice. Their median age was 49 yr. Both total office visits and services performed by endocrinologists (particularly for diabetes) increased substantially during the 1990s. Waiting time for an initial appointment is presently longer for endocrinologists than for other physicians. Compared with a balanced, largely closed-staff health maintenance organization, the current national supply of endocrinologists is estimated to be 12% lower than demand. The number of endocrinologists entering the market has continuously fallen over the previous 5 yr, from 200 in 1995 to 171 in 1999. Even if this downward trend were abruptly stopped, the model predicts that demand will exceed supply from now until 2020. Whereas this gap narrows from 2000 to 2008 due to projected growth of managed care, it widens thereafter due to the aging of both the population and the endocrine workforce. Inclusion of other factors such as projected real income growth and increased prevalence of age-related endocrine disorders (e.g. diabetes and osteoporosis) further accentuates the deficit. If the number of endocrinologists entering the workforce remains at 1999 levels, demand will continue to exceed supply from now through 2020 for adult endocrinologists, and the gap will widen progressively from 2010 onward. The present analysis indicates that the number of endocrinologists entering the workforce will not be sufficient to meet future demand. These data suggest that steps should be taken to stop the ongoing decline in the number of endocrinologists in training and consideration should be given to actions designed to increase the number of endocrinologists in practice in the years ahead.

Primary Medical Care in the United States: Present Status and Future Prospects

1972 ◽  
Vol 2 (2) ◽  
pp. 195-206 ◽  
Author(s):  
R. R. Huntley
Keyword(s):  
United States ◽  
Medical Care ◽  
Minority Group ◽  
Health Maintenance Organization ◽  
The United States ◽  
Future Prospects ◽  
Rural People ◽  
Health Maintenance ◽  
Primary Medical Care ◽  
Primary Physicians

The steady decline in primary physicians in the United States is documented. The increasingly severe maldistribution of physicians is examined in relation to the effect this has on primary care. The effect on the poor, rural people, and minority group people is particularly serious. Four approaches to the solution of this problem are identified and discussed in some detail: an increase in the output of physicians, an increase in the supply and use of ancillary support personnel, reform in the organization of medical care, and the creation of a new specialty of family practice. Special attention is devoted to the likely contribution of the Neighborhood Health Center and Health Maintenance Organization movements to solution of current problems in primary medical care.

A Comparison of Ambulatory Care and Selected Procedure Rates in the Health Care Systems of the Province of Manitoba, Canada; Kaiser Permanente Health Maintenance Organization; and the United States

1997 ◽  
Vol 10 (4) ◽  
pp. 26-34 ◽  
Author(s):  
Carolyn A. DeCoster ◽  
Marvin Smoller ◽  
Noralou P. Roos ◽  
Edward Thomas
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Care ◽  
Health Care Systems ◽  
Health Maintenance Organization ◽  
The United States ◽  
Kaiser Permanente ◽  
Financial Barriers ◽  
Health Maintenance ◽  
Care Systems

To determine if there are differences in physician services in different health care systems, we compared ambulatory visit rates and procedure rates for three surgical procedures in the province of Manitoba, Canada; Kaiser Permanente Health Maintenance Organization; and the United States. The KP system, with its single payer and low financial barriers, is not unlike the Canadian system. But, for most of the United States, the primary payment mechanism is fee-for-service, with the patient paying a significant amount, thereby militating against preventive and early primary care. Manitoba and KP data were extracted from computerized administrative records. U.S. data were obtained from publicly available reports, Manitoba provides 1.8 times and KP 1.2 times (1.4 when allied health visits are included) as many primary care physician visits as the United States. For the surgical procedures studied, U.S. rates were higher than those in either the KP HMO or in Manitoba. We conclude that (1) the U.S. system leads to more surgical intervention, and (2) removal of financial barriers leads to higher use of primary care services where more preventive and ameliorative care can occur.

scholarly journals Payments by Industry to Residency Program Directors in the United States

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Stein J. Janssen ◽  
David W.G. Langerhuizen ◽  
Gino M.M.J. Kerkhoffs ◽  
David Ring
Keyword(s):  
United States ◽  
Residency Program ◽  
Program Directors ◽  
The United States ◽  
Residency Program Directors

scholarly journals Global Health Curricula in Ophthalmology Residency Programs in the United States

2021 ◽  
Vol 13 (02) ◽  
pp. e183-e191
Author(s):  
Momoko K. Ponsetto ◽  
Nicole H. Siegel ◽  
Manishi A. Desai ◽  
Kara C. LaMattina
Keyword(s):  
United States ◽  
Global Health ◽  
Residency Program ◽  
Surgical Techniques ◽  
Program Directors ◽  
The United States ◽  
Residency Programs ◽  
Department Of Ophthalmology ◽  
Residency Program Directors ◽  
The Impact

Abstract Objective The aim of the study is to investigate the design, content, and administration of global health curricula within ophthalmology residency programs in the United States (U.S.) and share the curriculum utilized in the Department of Ophthalmology at Boston University School of Medicine (BUSM). Design A survey designed through the Association of University Professors in Ophthalmology platform was emailed to residency program directors at 106 accredited ophthalmology residency programs. Setting BUSM Department of Ophthalmology, Boston, MA. Tertiary clinical care. Participants Twenty-eight ophthalmology residency program directors responded, which represent 26% of the total number of residency programs in the United States. Twenty-seven programs fully completed the survey, and one program partially completed the survey. Results Of the respondents, three programs do not include global health curricula. The most common curricular elements included are: lectures (n = 15, 60%); wet laboratories (n = 10, 40%); and journal clubs (n = 9, 36%). In terms of annual frequency, global health activities occur: twice a year (n = 12, 46%); less than once a year (n = 10, 39%); or every few months (n = 4, 15%). Fewer than half of programs (n = 10, 42%) incorporate local outreach at least once a year into their program. Twelve programs (48%) do not incorporate ethics-related topics, while the 13 remaining programs (52%) incorporate them at least once annually. The most common curricular topic is surgical techniques, with manual small incision cataract surgery (MSICS) being the most frequently emphasized (n = 17, 68%). Conclusion A robust global health curricula combined with a hands-on international component can contribute to a well-rounded training experience. Many ophthalmology residency programs value the importance of incorporating global health into their residents' training. The most common elements of global health curricula in U.S. ophthalmology residency programs included are teaching of surgical techniques for resource-limited settings and international electives. Further investigation into the impact of different components of a global health curriculum on both resident experience and international partnerships is warranted.

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