<p>more med schools are being planned:</p>
<p>
[quote]
<a href="http://www.nytimes.com/2010/02/15/education/15medschools.html?hp%5B/url%5D%5B/quote%5D">http://www.nytimes.com/2010/02/15/education/15medschools.html?hp
[/quote]
</a></p>
<p>A quick scan through the article shows that they don’t even mention the frantic pace of D.O. school expansion. The osteopaths have lots of new schools either recently opened or on the horizon.</p>
<p>They are basically forcing these new schools to be primary care mills.</p>
<p>Its less about forcing the schools to be “primary care mills” and more about recognizing where the current medical education institutions have failed: we don’t need so many specialists living on the coasts. We need primary care physicians. We need medical schools that value and promote this career choice and that seek out students with compatible career goals!</p>
<p>I don’t think that its so much that these schools are going to focus on primary care as the fact the number of residency spots is not growing and the major openings are in primary care. New schools are at somewhat of a disadvantage when it comes to recruitment, and at first their students won’t have the reputation of their predecessors to lean upon.</p>
<p>Actually many of the new schools have declared mission statements about focusing on primary care.
As to disadvantage in recruitment, as a business enterprise, their is substantial unmet need for places in med schools!</p>
<p>Despite pressure to push students towards primary care, I promise you there’s little a school can do in the final decision making process. Most students have no idea what hospital medicine is really like, it’s easy to see yourself as working in an office the rest of your working life if your only interaction with physicians is in the office. </p>
<p>Besides, it always slays me how schools get evaluated as “primary care mills”. How do you even track when someone like myself goes into pediatrics…with the absolute intention of going into Peds Critical Care? Or what if I had started thinking gen peds and decided to do Peds Rheumatology (a particularly small specialty field in peds)?</p>
<p>At the risk of getting the smackdown I’ll just explain myself by saying I was mostly trying to emphasize that new schools tend to have to build themselves up (or continuously offer free/subsidized education) in order to get more competitive students. As the number of schools increases, the number of competitive applicants is not going to do so at the same rate (especially since there’s so much talk about rises costs and dropping salaries). Are there great applicants that don’t get into medical school and deserve it? Yes. Is there an unlimited number of those available to schools that are opening up and are not likely to be getting the most competitive student body? No. In fact, many of those applicants might have ended up going to Ross or SGU or otherwise abroad. If the competitiveness of the student body drops, some of that is going to carry over into residency applications too. Not 100% correlation, but there will be some. So what I was trying to get at, above any school policy of trying to push primary care, eventually the disparity in class competitiveness is going to also consign a lot of kids to less competitive specialties or more malignant residency, which are currently heavily occupied by FMGs. No school will ever have 100% of its class going primary care, just like no school completely specializes because interests run deeper than picking a competitive specialty (meaning I’m not trying to imply that BRM is going into peds because that was the only option) , but some have more kids that might want to go into radiology or derm but can’t.</p>
<p>Also, just want to emphasize that increasing the number of medical schools is not going to increase the number of doctors in our country, just the number of american medical school graduates that are doctors. Residency slots need to be increased as well.</p>
<p>
</p>
<p>+1 this is the main issue. All this means is that less FMGs (foreign medical graduates) will get residency spots in the US. Also, the osteopaths will become more reliant on their own residency system. But the number of funded residency spots needs to increase for there to be any major effect on the number of physicians.</p>
<p>the ability to promote primary care physicians is directly linked to the launching of new GME in these areas. Several of the med schools that are in the early stages of being launched are doing just that-launching new residency programs. Afterall this is an important aspect of LCME accreditation!</p>
<p>
</p>
<p>I would say that the promotion of primary care physicians is directly linked to the cessation of shafting primary care in the area of reimbursement, etc. Its not like there’s a shortage of primary care residency slots. The majority of Scramble slots are primary care. Simply increasing those numbers won’t do anything - we need to get people to want to go into primary care.</p>
<p>hence medical schools with admission focus on such individuals</p>
<p>
</p>
<p>Do you really think this works? It is extremely common for med students to change their intended specialty during school. And as BRM notes, the school can’t really do much if a student doesn’t want to go into primary care. If you look at the match lists of such schools, I’d bet almost anything that they have a similar primary care/specialty ratio to other schools.</p>
<p>It’s also easy to emphasize an interest in primary care with the full intention of going into other fields. The only programs that work in getting high levels of primary care practitioners are the ones that require it as the basis of admission or reimbursement. </p>
<p>One of the great things about medical schools in the US is, for the most part, you have the same opportunities as far as residency goes at all of them. If we go Law School style on our medical education system by boosting acceptance without increasing the average competitiveness of applicants, how long until we reach the point of a true tier system and extremely variable job opportunities.</p>