<p>I like this idea. </p>
<p>Also see some of the other funded proposals here:</p>
<p>[Grant</a> Projects | Accelerating Change in Medical Education | American Medical Association](<a href=“http://www.ama-assn.org/sub/accelerating-change/grant-projects.shtml]Grant”>http://www.ama-assn.org/sub/accelerating-change/grant-projects.shtml)</p>
<p>OHSU </p>
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<p>The bolded part makes it a particularly interesting program. I wonder why that’s part of it? Just a way to get people to try the new program that might fail or actually an integral part of it? What about people who want to experience that type of learning but don’t want to stay at their institution for residency?</p>
<p>I think it’s an integral part of the program since it appears to be all about speeding up the med school + residency process for PCPs and getting them out into community practice faster.</p>
<p>I don’t see any mention in plu’s link of the program being PCP focused. In fact they state their hope is this is successful enough to be expanded to other specialties but do not say “other primary care specialties.”</p>
<p>I don’t even think the overall goal is necessarily shorter training but it’s more likely a response to the fact that at many schools, the vast majority of students do not attend lectures and instead prefer to learn on their own. I wouldn’t be surprised if pediatrics was chosen just because it’s probably the specialty with the highest percentage of people who came in knowing they wanted to do it.</p>
<p>This is interesting. Several thoughts:</p>
<p>1) Peds likely chosen because it’s the first field to put together competency based education for ACGME requirements with the Pediatrics Milestones Project. That model is going to spread to other specialties, but it’s much more in line with the goal of this project in undergraduate education.</p>
<p>2) The guaranteed residency component - likely will help with some recruitment concerns. Those 4 programs are all pretty well regarded - Denver is probably the best out of the 4, but Utah is an incredibly strong program that comes in under the radar, the stigma of UCSF and being San Fran in general help draw applicants and Minnesota is quite strong. More importantly though, this concept is far more longitudinal than just undergraduate education, and in order to ensure the continuity and prove the concept, that continuation is vital to making it work. I worry though, what it’ll mean if they find favorable outcomes for this and how they’ll advance it and enmesh it with the current Match process and the movement inherent to medical training at this point.</p>
<p>3) I’m interested in seeing what the actual coursework is for the students that take part. A 9 month clerkship? Where does that time go, how do they get exposure to the other specialties that are on Step 2 and Step 3, which are needed for licensure. While there is the potential for greater continuity and seeing patients in multiple venues, I can tell you that 9 months is unlikely to generate much continuity outside of well baby visits - and I did residency at a place that was the only children’s hospital in the state, where I had all my patients guaranteed to come into my facility and I only had 2 patients that were “mine” in three years where I saw them in multiple locations in the hospital. There were kids with chronic medical conditions that every resident saw in the ER and on the floors and maybe in the PICU, but generally did not see in clinic settings. It’s a noble goal, and one that will try to fix the common complaint 3rd year med students have with clerkships which is the lack of continuity, but I’m not sure if it’ll work.</p>
<p>4) I’m curious what type of students this will draw. Pediatrics residencies have an interesting dichotomy, where many of the “top” residency programs attract a certain type of applicant, generally expecting to go into fellowship. There are programs that are focused on making academic physicians whether in gen peds or subspecialty, some that excel in producing general pediatricians and some that can actually do well in both. My residency program actually managed to produce great generalists and those going onto fellowship, while I’m doing fellowship at a location which is heavily “fellow-run”. When people ask me about the residents I work with, I have to say that they are much smarter than my group of residents, but in terms of being good doctors, the residents where I did residency were significantly better - and the ones who I would want taking care of my future children (independently without support from fellows or attendings). How all this translates to taking in medical students to a prolonged experience, I don’t know. Could be very interesting.</p>
<p>5) There’s so much inertia in medical training, and I wonder how/when this will be overcome. They’re really going to have to show that these students do better to get people to change…</p>
<p>^thank you for your insight.</p>
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<p>If I had to guess, they will be hard-pressed to find 4 students in UCSF Med who are targeting Peds. :rolleyes:</p>
<p>In 2012, they sent 19 students into Peds, which was apparently the most popular choice amongst that cohort.
[Medical</a> Students Mark ‘Match Day’ at UCSF | ucsf.edu](<a href=“http://www.ucsf.edu/news/2012/03/11715/medical-students-mark-match-day-ucsf]Medical”>Medical Students Mark 2013 'Match Day' at UCSF | UC San Francisco)</p>
<p>Have to remember that despite perceptions, pediatrics offers the 3rd largest number of residency spots each year (after categorical internal med and family).</p>
<p>Can’t figure out if the people graphed by UCSF for the prelim years are people who don’t have PGY2 spots or not. If you add everyone up you get 159 people but the article says 158. I’m leaning towards these people are people who do not have PGY2 spots lined up (rather than being double counted with their PGY2 specialty) but i’m kind of surprised that they’d have that many.</p>
<p>brm:</p>
<p>(correlation does not equal causation)…just because they sent xx into Peds after M4, does not mean those xx were targeting Peds as an M0.</p>
<p>Fair enough. </p>
<p>My point is, there’s still a sizable portion of students who will go into peds, and I believe it larger - even from the beginning of med school at a place like UCSF - than you give it credit for. At a minimum you have to account for a number of students who come in thinking peds and end up crossing it off the list later on. While every med school has one clerkship that everyone loves and ends up attracting the undecided (where I went to med school it was Internal Med, where I did residency it was Peds) and creating a few converts, knowing what I know about UCSF in the peds world (which isn’t a standout reputation compared to places like Boston, Cinci, Baylor) and given the reputation of other specialties there, I would be highly surprised if peds was that clerkship. Further, peds really doesn’t lend itself to “discovering” it as a passion - most people know if they like working with kids or they don’t. </p>
<p>In the end, I think they’ll have no problem filling their spots. And they may find a surge in applicants who want to do peds and are drawn to this program.</p>
<p>I looked up the match list at DS’s school in year 2012, the year I am able to find first.
About 11% chose ped.</p>
<p>It also appears many headed to ucsf in year 2013. But fewer in 2012.</p>
<p>“Choices of specialties covered the gamut, with close to 30 students choosing some form of primary care—15 in internal medicine, 11 in pediatrics, and four in family medicine. Five students matched in anesthesiology, eight in dermatology, five in diagnostic radiology, seven in emergency medicine, and seven in ophthalmology. A complete list of the graduates and their residencies follows.”</p>