Medical Training Costs Research Articles

Strategies to Reduce the Cost of Medical Education in India: A Narrative Review.

Background The global population is being plagued by several diseases and health conditions, and this calls for the need to adopt a strategy to enable people from all socioeconomic backgrounds to have the freedom and choice to opt for a medical profession as their career. The purpose of the current review is to explore the reasons which make medical education expensive and identify the strategies by which the cost of medical education can be minimized. Methods An extensive search of all materials related to the topic was performed on the PubMed search engine and web site of the National Medical Commission. Relevant research articles focusing on costs in medical education published in the period 2005 to 2021 were included in the review. A total of 37 articles were selected based on their suitability with the current review objectives and analyzed. Keywords used in the search include medical education and cost in the title alone only. Results We have to accept the fact that medical education is quite expensive and that's not the case with one nation but the trend is worldwide. It is the need of the hour to plan and implement strategies that make medical training accessible and available to people from all socioeconomic classes and regardless of other variables. Conclusion In conclusion, the process of training medical students is expensive and accounts for a wide range of impacts on the medical aspirants. Thus, there is an indispensable need for the policy makers and the concerned stakeholders to join their hands together and take appropriate steps to minimize the overall cost of medical training, and thereby making it affordable to everyone.

The GP retainer scheme: report of a national survey

WHAT IS ALREADY KNOWN IN THIS AREA• There is a small existing literature on the GP retainer scheme.• Some of the published studies have been rendered out of date by changes which have been made to the scheme since its inception in 1972.• Existing studies are supportive of the scheme whilst finding inconsistencies in provision of training and limitations due to the restriction to five years.• Previous studies rely on data from a single deanery (Webb,1,2 Muller,3 Hastie,4 Woodwark et al,5 Taylor,6 Smith et al7) or two neighbouring deaneries (O'Kelly8).WHAT THIS WORK ADDS• This unique national survey of the views and experiences of GP retainers is of particular interest to policy makers and clinical educators.• The current context of organisational change and new working patterns, together with the high cost of medical training, have increased the importance to the NHS of retaining its trained workforce.• The study shows the value of the retainer scheme in ensuring GPs retain and build skills and are not lost to the workforce, and points to limitations in implementation.SUGGESTIONS FOR FUTURE WORK• Research following subsequent career pathways over an extended period and research capturing the perspectives of practices employing GP retainers are both recommended.

Early Experience with Alternative Training Pathways: A View from the Trenches

In the United States, alternative training paradigms have been approved for vascular surgery and cardiothoracic surgery. The rate of adoption of these programs has been somewhat slower than was initially predicted. This article will summarize the collective experience of both authors with these programs, describe how they have integrated these new pathways into their university-based training programs, and illustrate the advantages and disadvantages of participation. The alternative training paradigms in vascular and cardiac surgery are similar in that they both allow training in general surgery and the respective subspecialty in 1 less year compared with the traditional pathways. It should be stressed that neither program is associated with a shortening of requirements for generalsurgerycertification;instead,12monthsoftrainingina specialty area (vascular surgery or thoracic surgery) counts toward both general surgery and specialty certification. In vascular surgery, the early specialization program (ESP) allows candidates to convert the “5 2” training paradigm (5 years of general surgery followed by 2 years of vascular fellowship) into “4 2” with board eligibility preserved in both general and vascular surgery. In cardiothoracic surgery, the joint surgery/ thoracic surgery program (JSP) allows trainees a “4 3” experience instead of a “5 2 or 3”. The 2 programs differ in that ESP participants complete all or most of their general surgery training by the end of the R4 year, whereas JSP residents have a blended thoracic and general surgery experience during R4 and R5. In the ESP, the chief resident experience in general surgery occurs during the R4; in the JSP, the chief residency year in general surgery is shared between the R4 and R5 clinical years, and it is intermixed with additional months of cardiothoracic training. Essentially, the ESP resident completes the general surgery experience before matriculating into vascular training, whereas the JSP participant gains an additional 12 months of cardiothoracic surgery training before completion of the combinedprogram.Boardeligibilityinbothgeneralsurgeryandthe respective subspecialty are achieved in these pathways. The authors have had the largest experiences in the country with the early specialization program (ESP) and the joint surgery/thoracic surgery program (JSP) pathways. The purpose of this article is to describe the combined experience of both authors with these 2 training pathways at Barnes Hospital/ Washington University (Barnes/WU) and University if Texas Southwestern (UTSW), where both authors serve as general surgery program directors. Both programs were early adopters of these alternative pathways, and they currently have trainees in both tracks. The authors acknowledge that the combined experience is too early and the number of participants too few to reportmeaningfuldatathatmightbeusedtocompareeducational outcomes with the traditional pathways. Likewise, the impact of shortened training pathways on patient safety, medical training costs, and benefit to society as a whole will need to await the analysis of a larger experience. Nevertheless, the authors have learnedseveralpracticallessonsfromadoptingthesenewprograms

The Net Costs of Medical Training

One of the stages of medical training is the internship, where doctors-to-be (interns) face the real world of medical practice for the first time, under the supervision of a graduated physician. According to the career choice, the internship takes place at a provider of primary or secondary care. Hosting institutions often claim compensation for the training provided. The goal of this study is to identify the impact of the presence of the interns on the costs of providing care by the hosting institutions. We contribute by jointly considering several important effects. On the one hand, interns are a fixed exogenous factor on the beginning of their learning curve, taking extra time and resources from both the hosting institution and the supervisor. On the other hand, interns can be regarded as a less expensive substitute to nurses and/or graduate physicians, in the production of health care, both in primary care centres and hospitals. Therefore, interns are a specific input that hosting institutions take into account when organizing health care delivery. The net effect can be either positive or negative. The data used comes from Portuguese primary care centres and hospitals. Regression analysis was used to estimate their impact on the cost structure. The results point out to a negligible impact of the interns in the total cost structure of primary care hosting institutions. In the case of hospitals, the presence of interns represents an extra cost to the institution, above the yearly wage. Furthermore, there is a positive relation between dimension and cost to the hospital. Therefore, net training costs (defined as the costs incurred by the hosting institution above the wage paid) seem to be largely compensated by the activity performed by interns, and training compensations, over and above the interns salary should be relatively minor.