New Allopathic Medical Schools Train Fewer Family Physicians Than Older Ones

Brian Beachler, MD; Yalda Jabbarpour, MD; Douglas B. Kamerow, MD, MPH; Elizabeth Wilkinson, BA; Zachary Levin, BA; Andrew Bazemore, MD, MPH

Disclosures

J Am Board Fam Med. 2019;32(5):653-654. 

The first significant expansion of allopathic medical schools since the 1970s was anticipated to produce more physicians capable of addressing the nation's current and projected primary care shortages. However, our analysis of the early outputs of new allopathic medical schools suggests that these students were nearly 40% less likely to specialize in family medicine than existing schools.

The likelihood of future shortages of adult primary care physicians is of great concern for policy makers as the US population grows and ages.[1] Responding to projections of physician shortages in particular specialties and geographies, the Liaison Committee on Medical Education accredited 26 new allopathic medical schools between 2002 and 2018.[2,3] Other investigators have not evaluated whether graduates from these institutions are entering fields with the greatest shortages, such as family medicine.

We used the 2018 American Medical Association Masterfile to compare self-reported specialty choice of resident physicians who graduated from the 14 US allopathic medical schools that were accredited after 2002 to those at the remaining 118 US allopathic schools, for the years 2015 to 2017. The remaining newly accredited medical schools did not have a graduating class at the time of the analysis and are not included. We limited our analysis to resident physicians 3 years from medical school graduation; therefore, subspecialties are not represented in this analysis. The number of physicians from new allopathic medical school graduating early enough to have entered subspecialties by the time of the survey was too small for comparison. We found that graduates of the new medical schools were nearly 40% less likely than their colleagues at established medical schools to enroll in family medicine residency programs (Table 1). They were more likely to seek residency training in adult specialties such as general surgery (30%) and OB/Gyn (42%).

Expanding primary care access has clear relationship to better health outcomes and lower costs.[4] A limited primary care workforce puts those benefits at risk. Increasing specialization among internists and pediatricians, paired with the growth of our aging population, leaves primary care physician growth particularly dependent on family medicine. While a small number now, students from new allopathic medical schools are projected to account for 39% of the total growth in allopathic enrollees by 2022, putting these schools in a unique position to fill the need in the primary care workforce.[3] As more medical schools graduate their first class of students, further studies will need to investigate whether the trend presented here is persistent and if workforce needs are being appropriately addressed by medical school expansion.

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