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Many U.S. Medical Schools Give Boost to Primary Care as They Increase Enrollments
By Barbara Bein
The report is based on the seventh annual survey of deans of U.S. medical schools accredited or preliminarily accredited by the Liaison Committee on Medical Education. The report found that first-year medical school enrollment has increased from 16,488 students in 2002 to 18,665 in 2010, an increase of more than 13 percent. In addition, enrollment is expected to increase an additional 28 percent by 2015.
"There can be little doubt that the medical education community has risen to the challenge of achieving the (recommended) 30 percent growth in first-year enrollment," the report says. "Whether by 2015, 2016 or 2017, it currently appears that the goal will be met."
The Effect on Primary Care
Many of the medical school deans answering the questionnaire, however, also expressed concern about the supply of student clinical clerkship positions and qualified preceptors, especially primary care preceptors, needed to meet the increased number of medical students.
According to Perry Pugno, M.D., M.P.H., the AAFP's vice president for education, there are other trends that could affect the numbers, as well. For example, "We need to encourage the medical school deans to stop counting all students who enter family medicine, internal medicine and pediatrics residencies as indicative of those seeking careers in primary care," he said. "We know very well that the vast majority of those entering internal medicine and pediatrics residencies will eventually gravitate toward subspecialty fellowships and not primary care."
Pugno added that he is hopeful that "the new medical schools, in particular, will ensure that their primary care initiatives truly encourage medical students toward practices in family medicine, general internal medicine and general pediatrics."
The Osteopathic Factor
By 2015, allopathic medical and osteopathic schools will have a combined enrollment increase of 35 percent, producing almost 7,000 more new doctors every year compared with the number produced in 2002, says the report.
However, the report's authors also recommend continuing to monitor trends in medical school enrollment, particularly as health insurance coverage expands because of the Patient Protection and Affordable Care Act, which likely will create a need for more physicians.
In addition, the report found that more schools in 2010 than in 2009 -- 52 percent versus 39 percent -- expressed concern that the current economic environment will limit their ability to maintain or increase enrollment.
Pugno agreed. "I am indeed concerned that the limits to expansion of GME (graduate medical education) positions, as well as the nation's economic pressures on residency education, will hamper the efforts to increase the production of primary care physicians.
"We truly need a program that will leverage the opening of new, primary care GME positions preferentially."
Policy on Family Physician Workforce Reform
Primary Care Focus of Increased Medical School Enrollment