scholarly journals Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

scholarly journals Medical Students’ Attitudes towards Careers in Primary Care in Singapore

2020 ◽  
Author(s):  
Humairah Zainal ◽  
Helen Elizabeth Smith
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
Medical Schools ◽  
School Experience ◽  
Ageing Population ◽  
Family Doctors ◽  
Students Attitudes

Abstract Background: Singapore needs more family doctors to care for its ageing population and their chronic conditions. To boost the recruitment of doctors within primary care, we need to better understand medical students’ attitudes and experience of General Practice and Family Medicine. While many studies have explored the facilitators and barriers to teaching undergraduate medical students in this field of medicine from the perspectives of GP teachers and trainers, few have examined students’ exposure to primary care in medical schools. Although there are works on factors influencing students’ attitudes towards primary care careers, the roles of medical schools, professional bodies and state institutions tend to be discussed independently of one another. This article explores medical students’ perceptions towards careers in primary care and how different stakeholders might collaborate in strengthening the medical school experience. Methods: Six focus groups involving 54 students from three medical schools in Singapore were conducted. Discussions focussed on their primary care experience, their professional and career aspirations, and perceptions towards the opportunities and challenges of primary care careers. Thematic analysis was used to interpret the qualitative data. Results: 15 key themes emerged from the discussions; 10 reflected key concerns of pursuing primary care careers whereas 5 others highlighted their positive aspects. The former include society’s perceptions of primary care professions as sub-standard, specialists’ negative attitudes towards family doctors, the emphasis on the lifestyle benefits of primary care careers rather than their professional characteristics, mundane case mix, limited professional opportunities, lack of continuity of care, limited consultation time, low remuneration, need for business acumen, and conflicts created by business in clinical care. However, the respondents also articulated positive views, including its lifestyle benefits, autonomy of private practice and better patient care, opportunities for entrepreneurialism and a portfolio career, breadth of clinical problems presented, and an improved future for General Practice and Family Medicine. Conclusion: The findings demonstrate that coordinated initiatives from multiple stakeholders would help to increase the attractiveness of primary care as a career choice among students. Improvements in the medical school experience will significantly enhance the prestige of General Practice and Family Medicine.

scholarly journals Opinion and Special Articles: Neurology education at US osteopathic medical schools

Neurology ◽  
2017 ◽  
Vol 89 (24) ◽  
pp. e282-e283 ◽  
Author(s):  
Daniel A. Freedman ◽  
Dara V.F. Albert
Keyword(s):  
United States ◽  
Primary Care ◽  
Medical Students ◽  
American Academy ◽  
Primary Care Physicians ◽  
Active Role ◽  
Medical Schools ◽  
The United States ◽  
Clinical Neurology ◽  
Core Clerkship

Osteopathic medical schools have a longstanding tradition of training primary care physicians (PCP). Neurologic symptoms are common in the PCP's office and there is an undersupply of neurologists in the United States. It is therefore crucial for osteopathic medical students to have a strong foundation in clinical neurology. Despite the importance, a mere 6% of osteopathic medical schools have required neurology clerkships. Furthermore, exposure to neurology in medical school through required clerkships has been correlated with matching into neurology residency. As osteopathic medical schools continue to expand, it will become increasingly important to emphasize the American Academy Neurology's published guidelines for a core clerkship curriculum. Practicing neurologists should take an active role in encouraging osteopathic medical schools to adopt these guidelines.

Medical schools, primary care and family medicine: clerkship directors’ perceptions of the current environment

2019 ◽  
Vol 36 (6) ◽  
pp. 680-684
Author(s):  
Maribeth Porter ◽  
Denny Fe Agana ◽  
Robert Hatch ◽  
Susmita Datta ◽  
Peter J Carek
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Medical School ◽  
School Environment ◽  
Student Attitudes ◽  
Primary Care Physicians ◽  
Specialty Choice ◽  
Medicine Clerkship ◽  
Negative Comments ◽  
The Usa

Abstract Background The culture at a medical school and the positive experiences in primary care clerkships influence student specialty choice. This choice is significant if the demand for primary care physicians is to be met. The aim of this study was to examine family medicine clerkship directors’ perceptions of the medical school environment. Methods Data were collected as part of the 2015 Council of Academic Family Medicine Educational Research Alliance Family Medicine Clerkship Director survey. Questions asked included how clerkship directors perceived the environment of their medical school towards family medicine, has the environment towards family medicine changed between 2010 and 2015, do they take action to influence student attitudes towards family medicine and whether faculty members in other departments make negative comments about family medicine. Results The response rate was 79.4%. While most respondents indicated the environment of their medical school has become more positive towards family medicine, a majority of clerkship directors perceived the environment to be either very much against, slightly against or indifferent towards family medicine. Nearly one-half (41.4%) of the clerkship directors were notified more than once a year that a faculty member of another department made a negative comment about family medicine. Results varied among regions of the USA and between schools located in the USA and Canada. Conclusion Family medicine clerkship directors often perceived negativity towards family medicine, a finding that may limit the effectiveness of academic health centres in their mission to better serve their community and profession.

scholarly journals Factors That Influence Student Choice in Family Medicine

2019 ◽  
Vol 51 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Mustafa Alavi ◽  
Tiffany Ho ◽  
Chandler Stisher ◽  
Emma Richardson ◽  
Christina Kelly ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Focus Groups ◽  
Institutional Support ◽  
Medical Schools ◽  
Care Physician ◽  
Student Choice ◽  
Medicine Physician ◽  
Fourth Year Medical Students

Background and Objectives: The Family Medicine for America’s Health Workforce and Education Team aims to increase the number of medical students choosing family medicine to address the projected primary care physician shortage. This aim can be achieved by developing a well-trained primary care workforce. Our student- and resident-led FMAHealth work group aimed to identify factors that influenced fourth-year medical students’ choice to become family physicians. The secondary objective compared such factors between the 10 medical schools with the highest percentage of students matching into family medicine and non-top 10 medical schools. Methods: Fourth-year medical students nationwide participated in 90-minute virtual focus groups. Reviewers coded deidentified transcriptions and identified key themes and subthemes that were found to influence student choice. Results: Fifty-five medical students participated in focus groups over a 2-year period. Three key themes were found to influence students: perspective, choice, and exposure. Subthemes included: (1) the importance of high-quality preceptors practicing full-scope family medicine, (2) the value of a rural experience, and (3) institutional support to pursue family medicine. Physician compensation and loan repayment concerns were not major factors influencing student choice. Conclusions: Many factors influence student choice of family medicine including preceptors, clinical exposures, and institutional support. These factors varied by institution and many were found to be different between top 10 and non-top 10 schools. Addressing these factors will help increase students’ choice of family medicine and reduce the primary care shortage.

scholarly journals Improving Hierarchical Condition Category Coding by Family Medicine Residents Using a Web-Based, Interactive Module

2021 ◽  
Vol 53 (3) ◽  
pp. 220-222
Author(s):  
Stuart Zeltzer ◽  
Monique Vanderhoof ◽  
Brian Garvey
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Response Rate ◽  
Positive Impact ◽  
Clinical Communication ◽  
Web Based ◽  
Knowledge Question ◽  
Junior Residents ◽  
Family Medicine Residents ◽  
Hierarchical Condition Category

Background and Objectives: The proper documentation of Hierarchical Condition Category (HCC) codes is essential for risk-adjusted reimbursement, chart accuracy, and clinical communication within primary care, but represents a significant training gap in resident education. Our goal was to improve the understanding and confidence level of family medicine residents with HCC coding during outpatient primary care visits. Methods: We developed and distributed a web-based, interactive module to family medicine residents at our academic institution. We assessed module impact through pre- and postsurveys focusing on knowledge, confidence, and experience with HCC coding. Results: Twenty-eight of 48 preeducation surveys were returned (response rate of 58%), including 16 junior (PGY-1-2) and 12 senior (PGY-3-4) residents. A majority of residents answered each HCC knowledge question correctly. Median baseline confidence with HCC coding for all respondents was 4 (interquartile range [IQR]: 2, 6; scale 0-10; 10=most confident): senior residents 6 (IQR: 5, 7) versus junior residents 2 (IQR: 2, 4). Forty-six percent of respondents noted some previous education on HCC codes, including 75% of senior vs 25% of junior residents. Twenty-six residents completed the educational module. Posttest surveys (n=5, response rate: 19%) demonstrated median confidence of 7 (IQR: 4, 8.5). Conclusions: Family medicine residents displayed a high degree of knowledge but low confidence with HCC coding. Posteducation surveys suggest the possibility of a positive impact of our e-module, though further intervention roll out and data collection are needed to evaluate this effect.

scholarly journals Inspiring Medical Students to Choose Primary Care Through Lifestyle Medicine Education

2020 ◽  
Vol 14 (6) ◽  
pp. 602-605
Author(s):  
David I. Bermejo ◽  
Regan A. Stiegmann
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Nutrition Education ◽  
Primary Care Physicians ◽  
Medical Schools ◽  
Primary Care Providers ◽  
The United States ◽  
Care Providers ◽  
Lifestyle Medicine ◽  
Medicine Education

Despite a growing interest in lifestyle medicine, students at most medical schools in the United States are not receiving enough nutrition education and training in the principles of lifestyle modification to be effective at applying this knowledge to real-world clinical practice. Moreover, the rising prevalence of chronic lifestyle-related diseases and the increasing deficit of primary care providers is overwhelming the US health care system. The need for primary care physicians is being circumvented by medical students’ diminishing interest in primary care partly due to concerns about salary, prestige, and being too broad in focus. Students may also recognize that the pharmaceutically based management of chronic conditions and supplemental lifestyle recommendations are often fraught with nonadherence, resulting in the progression of disease states. However, some medical schools have incorporated the concepts and practice of lifestyle medicine into their curriculums. This integration has the potential to inspire medical students to choose a primary care specialty, because students become more adept at addressing and treating the root causes of chronic disease. Lifestyle medicine education can empower students interested in primary care to fulfill their initial desires to treat and heal that may have inspired them to want to become doctors in the first place.

scholarly journals How prepared are medical students to diagnose and manage common ocular conditions

2014 ◽  
Vol 11 ◽  
pp. 29 ◽  
Author(s):  
Elizabeth Shanika Esparaz ◽  
S. Bruce Binder ◽  
Nicole J. Borges
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Average Score ◽  
Passing Rate ◽  
Fourth Year Medical Students ◽  
Second Year ◽  
Student’S T ◽  
Quiz Scores

It is essential that primary care physicians have a solid fund of knowledge of the diagnosis and management of common eye conditions as well as ocular emergencies, as management of these diseases commonly involves appropriate referral to an ophthalmologist. Thus, it is crucial to receive comprehensive clinical knowledge of ophthalmic disease in the primary care setting during medical school. This study investigated how well prepared medical students are to diagnose and manage common ocular conditions. The study used scores from a standardized 12-question quiz administered to fourth-year medical students (N = 97; 88% response rate) and second-year medical students (N = 97; 97% response rate). The quiz comprising diagnosis and referral management questions covered the most frequently tested ophthalmology topics on board exams and assessed students’ ability to recognize when referral to an ophthalmologist is appropriate. Fourth-year medical students had quiz scores ranging from 0%-94.5% with an average score of 68.7%. Second-year students had quiz scores ranging from 27.2%–86.4%, with an average score of 63.8%. Passing rate was 70%. Student’s t-test showed fourth-year students had a significantly higher quiz average (P = 0.003). In general, both classes performed better on diagnostic questions (fourth-year, 73.7%; second year, 65.8%) rather than on management questions (fourth-year, 64.8%; second year, 61.8%). Both second-year and fourth-year students on average fell short on passing the ophthalmology proficiency quiz, and in general students were more adept at diagnosing rather than managing ocular conditions and emergencies.

scholarly journals The Effect of Teaching Family Medicine Clerkship Students on Preceptor Productivity

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Tomoko Sairenji ◽  
Samuel Griffin ◽  
Misbah Keen
Keyword(s):  
Primary Care ◽  
Medical Student ◽  
Family Medicine ◽  
Student Teaching ◽  
Primary Care Physicians ◽  
Clinical Teaching ◽  
Medical Student Education ◽  
Billing Data ◽  
Medicine Clerkship ◽  
Number Of Patients

Introduction: High-quality, experiential learning in outpatient settings is indispensable for medical student education; however these settings are difficult to recruit and retain. The majority of primary care physicians are employed by organizations and are under pressure to increase their relative value unit (RVU) production. Although the common perception that teaching medical students decreases productivity is unproven, it is likely a barrier for primary care physicians pursuing clinical teaching. We sought to investigate whether medical student teaching affects clinical productivity. Methods: We recruited 15 family medicine (FM) clerkship sites to participate in our study via email and at an in-person meeting. For each preceptor, we collected billing data in the form of current procedural terminology (CPT) codes for all patient encounters and the number of patients seen per half-day for when the preceptor had a student and when they did not. We converted CPT codes to RVU data. We compared differences in productivity for each individual preceptor, and we used a paired t test to examine collective data with and without a student. Results: Ten preceptors at six FM clerkship sites provided reliable data. The average RVU per half-day without a student was 10.84, and it was slightly higher at 11.25 when a student was present (P=.74). The average number of patients seen per half-day without a student was 8.32 and it was slightly lower at 7.87 when a student was present (P=.58). Conclusion: This study shows promising data that teaching students in the outpatient setting does not decrease preceptor productivity. This pilot study can lead to a larger-scale exploration of family medicine preceptor productivity in different settings and institutions.

scholarly journals Knowledge of final-year medical students at the University of KwaZulu-Natal about family medicine, and long-term career choices

2019 ◽  
Vol 61 (1) ◽  
Author(s):  
R. Omed Ali ◽  
A. J. Ross ◽  
T. C. Nkabinde
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Healthcare Delivery ◽  
Care Physician ◽  
Kwazulu Natal ◽  
Care Family ◽  
The University ◽  
Health Programmes

Background: While international experience suggests that well-trained primary care physicians improve the quality and cost effectiveness of health care, family medicine (FM) as the discipline of the specialist primary care physician appears to not be an attractive career for medical graduates in South Africa (SA). The aim of this study was to establish final-year medical students’ knowledge about FM and its relevance to the healthcare system, explore their perceptions of the discipline’s relevance, and identify their specialty preference.Methods: This was a descriptive study conducted amongst final-year medical students at the University of KwaZulu-Natal (UKZN) in 2017 at the conclusion of their seven-week FM module. Data were collected using a self-administered questionnaire and results were analysed descriptively.Results: The response rate of completed questionnaires was 80.2% (157/196). Students reported limited exposure to FM in their early undergraduate years and low levels of awareness about essential public health programmes. Students showed good awareness of the six roles of family physicians (FPs), but FM was only the sixth most popular choice for specialisation.Conclusions: In general, students had favourable views concerning FM and its role in the future of healthcare delivery in SA, although their knowledge of essential health programmes was poor. The majority of students had limited interest in pursuing a career in FM. A key recommendation to address these issues is to introduce FM into the curriculum earlier, to cover the key roles of the FP, and provide teaching that highlights the relevance of FM to health system programmes.

scholarly journals Comparing Medical Students’ and Preceptors’ Views of a Longitudinal Preclerkship Family Medicine Course

PRiMER ◽  
2018 ◽  
Vol 2 ◽  
Author(s):  
Karen Willoughby ◽  
Charo Rodríguez ◽  
Miriam Boillat ◽  
Marion Dove ◽  
Peter Nugus ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Response Rate ◽  
Student Survey ◽  
Medical Undergraduate ◽  
Mcgill University ◽  
Perceived Effects ◽  
Evaluative Research

Introduction: Despite the increasing popularity of longitudinal primary care experiences in North America and beyond, there is a paucity of work assessing these medical undergraduate experiences using reliable and valid questionnaires. Our objective in this study was to evaluate a new preclerkship longitudinal family medicine experience (LFME) course at McGill University by assessing family physician preceptors’ self-reported ratings of the perceived effects of this course, and to compare their responses with ratings provided by medical students who completed the course. Methods: This study is part of a larger evaluative research project assessing the first edition of the LFME. Students (N=187) and preceptors (N=173) of the 2013-2014 cohort were invited to complete separate online questionnaires in the spring through summer of 2014. The preceptor survey contained 53 items, 14 of which were nearly identical to items in the student survey (published elsewhere) and served as the basis for comparing preceptor and student ratings of the LFME. Results: Ninety-nine preceptors (57% response rate; 55% female) and 120 students (64% response rate; 58% female) completed the surveys. Preceptors and students did not significantly differ in their overall ratings of the course, as both groups were satisfied with the quality of the LFME and felt it was an appropriate and valuable educational experience. However, preceptors had more positive ratings regarding their role and the benefits of the course than did medical students. Conclusion: This study corroborates prior work showing extensive perceived benefits of longitudinal preclerkship exposure to primary care; however, preceptors were found to report more positive reviews of the course than students. This study also provides new innovative tools to assess students’ and preceptors’ perceptions of longitudinal, preclerkship family medicine courses available for use over time and in different educational contexts.

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