Graduate medical education and primary care workforce: a CERA study

Abstract

Background: In the next 10 to 15 years, the Association of American Medical Colleges (AAMC) estimates a shortage of physicians. In conjunction, the demand for primary care physicians will increase, the type of physician associated with better population health at lower health care costs. The objective of this study is to examine the opinions of family medicine residency directors (FMRD) regarding the potential impact of recent publicized recommendations on the primary care physician workforce in the United States.

Methods: This project is part of a larger CERA omnibus survey with survey methods and sample demographics presented previously. Additional analysis was conducted using chi square and logistic regression using type of residency, size of community, years as program director, year program began, gender, and geographic region as predictors of agreement.

Results: A large proportion of responding FMRD disagree or strongly disagree that increasing medical school size or number of total resident positions in all specialties would result in an increase in the number of medical school graduates choosing a career in primary care Most respondents feel that increasing compensation for those practicing in primary care would have greatest impact on increasing medical school graduates who choose primary care. A minority of responding directors feel the length of family medicine residency training should be 4 years.

Discussion: While numerous recommendations have recently been made, most responding FMRD feel that changing reimbursement for primary care physicians would have the greatest impact on the workforce.