Shortage Of Physicians Research Articles

[Expectations And Motivations Of Young Occupational Medical Physicians: A Quantitative Survey Of Five German Academies].

The aim of this study was to describe the characteristics of future occupational physicians and to evaluate their expectations from and motivations for undertaking postgraduate medical education courses in occupational medicine. This will provide a basis for further increasing the attractiveness of occupational medicine as a discipline in preventive medicine and counteracting the shortage of occupational medical physicians. At five locations in Germany, physicians in postgraduate medical education courses in occupational medicine were asked about their expectations from occupational medicine, their reasons for starting postgraduate medical education courses, and their assessment of these courses. The survey took place between 2018 and 2021. The data were analysed descriptively, and a cluster analysis was applied to identify the types of motives for continuing postgraduate medical education courses in occupational medicine. Of the 233 respondents, the majority were female (68.5%) and the mean age was 43.1 years (SD 7.9 years). The response at the State Chamber of Physicians of Saxony was 50% and at the remaining four academies was between 18% and 23%. The analysis revealed four different types of motives: "career & interest", "work & life balance", "self-employment" and "desire for change". Two-thirds of the participants were in favour of a greater integration of occupational medicine into medical school curriculum. The results suggest that there are different motives that lead physicians to pursue continuing education in occupational medicine. These motives should be considered when recruiting young occupational physicians.

Cultivating a “Feminine” Surgical Culture: Lessons from Indonesia

Background: Despite a growing number of female physicians, most practicing surgeons in the U.S. are still men. By contrast, Indonesia has achieved notable gender parity among surgeons, with the number of women practicing as plastic surgeons projected to soon surpass men. Achieving more female representation in plastic surgery is important for delivering high-quality care, especially in the face of physician shortages and high burnout. Methods: This survey study was conducted at the 26th Annual Scientific Meeting of the Indonesian Association of Plastic Reconstructive and Aesthetic Surgeons (InaPRAS) in Manado, Indonesia, during August 2023. Respondents were asked about their perceptions of plastic surgery, mentorship, career motivations, and caregiving responsibilities. Responses were scored using a 3-point Likert scale of agreement to statements (Disagree, Neutral, Agree); χ2 and Fischer’s exact test were performed to assess differences in responses by gender. Results: In this validated survey of 175 plastic surgeon trainees and attendings, there were no significant difference between genders in the perception and roles of mentorship in preparing for a career in plastic surgery. Respondents for both genders espoused optimistic views on work-life balance items, including time for family and friends and flexibility of work schedules. Conclusion: Indonesia can serve as a model for encouraging greater gender parity in plastic surgery. Community-level interventions such as family leave policies, childcare provisions, and initiatives to promote an inclusive culture will create a more supportive workplace to increase women’s representation in plastic surgery in the United States and around the world.

Academic Medicine and Rural Health System Partnerships: Enhancing Education While Advancing Physician Workforce Priorities.

A worsening shortage of rural physicians paralleling increasing health disparities demands attention. Past and ongoing efforts to address this shortage have had positive effects and can inform new strategies to achieve even greater impact. Interventions have included the development of regional medical school campuses and rural-focused tracks to recruit medical students from rural areas, expansion of rural-based graduate medical education (GME) programs and tracks, and use of institutional and individual financial incentives for rural-based training and/or practice. National policy has also taken aim at this challenge with provisions aimed at expanding rural GME in the Medicare, Medicaid, and State Children's Health Insurance Program Balanced Budget Refinement Act of 1999 and the Consolidated Appropriations Act of 2021. Additionally, several states have funded growth in GME, and supportive pathways for Medicare reimbursement and for Veterans Administration funding have been implemented. The authors recommend a new strategy for bolstering the rural physician workforce, focused on using academic-rural partnerships to incorporate rural rotations as a routine part of GME. They explain how the current health care landscape supports this approach and outline additional steps toward implementation. Centralized data collection and analysis are noted as essential to guide future efforts.

Overcome Medical Algorithm Aversion: Conditional Joint Effect of Direct and Indirect Information

The just-ended COVID-19 pandemic and the looming global aging remind us that we need to be prepared for the shortage of doctors, which might become an urgent medical crisis in the future. Medical AI could relieve this urgency and sometimes perform better than human doctors; however, people are reluctant to trust medical AI because of algorithm aversion. Although several factors that can minimize algorithm aversion have been identified, they are not effective enough to promote medical AI as people’s first choice. Therefore, inspired by the direct and indirect information model of trust and media equation hypothesis, this research explored a new method to minimize aversion to medical AI by highlighting its social attributes. In 3 between-subject studies, a medical AI system’s direct information (i.e., transparency and quantitation of the decision-making process (DMP)) and indirect information (i.e., social proof) were manipulated. Study 1 (N = 193) and 2 (N = 429) showed that transparency of DMP and social proof increased trust in AI, but did not affect trust in human doctors. Social proof jointly affected trust in AI with non-quantitative DMP but not quantitative DMP. Study 3 (N = 184) further revealed the joint effect of the transparent non-quantitative DMP and near-perfect social proof, which could minimize algorithm aversion. These results extended the direct-indirect information model in interpersonal trust, revealed conditional media equation in human-AI trust, and offered practical implications for medical AI interface design.

The use of voluntary health insurance in the access to specialist care: Evidence from the Italian NHS

We examine whether the endorsement of voluntary health insurance (VHI) in a Beveridge-oriented healthcare system may increase the probability of visiting a specialist. We use data from the 2019 European Health Interview Survey, which includes information on demographics, socioeconomic characteristics, health status, and healthcare access of over 30,000 Italian households. We also apply data from the Health for All dataset to measure the supply of physicians at regional level.In order to account for endogeneity and unobserved heterogeneity, data is modeled through a simultaneous equation model for binary variables, specifically a trivariate recursive probit.Findings show a positive impact of VHI on the probability of accessing specialist care, after controlling for physician distribution. A socioeconomic gradient is also detected in the probability of both holding VHI and visiting a specialist, with wealthier and better educated individuals showing more likelihood to do so; these results raise concern on the equity of access granted by a Beveridge-oriented system. The role of the GP in filtering the need for care and referring patients to specialists is also recognized. Both supplier inducement effects and macroregional fixed effects are detected in the access to either category of physicians.

DETECTA – MULTIPLE DISEASE DETECTION

Machine Learning Techniques for Predictive Analytics in Healthcare There are multiple techniques in machine learning that can in a variety of industries, do predictive analytics on large amounts of data. Predictive analytics in healthcare is a difficult endeavor, but it can eventually assist practitioners in making timely decisions regarding patients' health and treatment based on massive data. Diseases like Breast cancer, diabetes, and heart-related diseases are causing many deaths globally but most of these deaths are due to the lack of timely check-ups of the diseases. The above problem occurs due to a lack of medical infrastructure and a low ratio of doctors to the population. The statistics clearly show the same, WHO recommended, the ratio of doctors to patients is 1:1000 whereas India's doctor-to- population ratio is 1:1456, this indicates the shortage of doctors. The diseases related to heart, cancer, and diabetes can cause a potential threat to mankind, if not found early. Therefore, early recognition and diagnosis of these diseases can save a lot of lives. This work is all about predicting diseases that are harmful using machine learning classification algorithms. In this work, breast cancer, heart, and diabetes are included. To make this work seamless and usable by the mass public, our team made a medical test web application that makes predictions about various diseases using the concept of machine learning. In this work, our aim to develop a disease-predicting web app that uses the concept of machine learning-based predictions about various diseases like Breast cancer, Diabetes, Heart diseases, Covid, Pneumonia, Alzheimer.

Migration and professional mobility: Rural attraction and retention of South African educated physicians

Rural communities in Alberta, Canada have faced physician shortages for decades. Attracting internationally educated physicians, including many South African physicians, is one way to address this problem. While much of the research on international medical graduates (IMGs) focuses on the push and pull of attraction and retention, I situate the decision to stay as a matter of geographic and professional mobility, all within a life course perspective. More specifically, I explore physicians' decisions to migrate from South Africa to rural Alberta and the impact of professional mobility on their migrations. To understand the processes, I collected data via semi-structured virtual interviews with 29 South African educated generalist/family physicians with experience in rural Alberta. Research was guided by abductive grounded theory and data was analysed using open thematic coding. I found that South African educated physicians made the decision to leave South Africa and to come to Canada to pursue prestige and opportunity they perceived to be inaccessible in South Africa. However, physicians were limited to perceived low prestige work as rural generalists, while they understood that more prestigious work was reserved for Canadian educated physicians. Physicians who remained in rural communities brought their aspirations to life, or achieved upward professional mobility in rural communities, through focused clinical and administrative opportunities. The decision to leave rural communities was often a matter of lifestyle and burnout over prestige.

On-site peer mentorship's effect on personal and professional development, stress reduction, and ease of transition into the medical education system.

Mentorship aids in the transition into the medical education system, which is a demanding and stressful time for learners. The development of new medical schools to offset the physician shortage has posed a challenge in that the inaugural class of students lacks an upperclassman cohort as a resource for advice and mentorship. Mentorship has proven to have positive impacts on three domains: personal and professional development (PPD), stress reduction (SR), and ease of transition (ET) into medical school. The purpose of this study was to identify sources of mentorship within the medical education system and compare the subjective growth of the inaugural and second classes of a newly established medical school in the three domains. The inaugural and second classes at a newly established medical school completed an Institutional Review Board (IRB)-approved anonymous survey with questions pertaining to unidentifiable demographics, sources of mentorship, and a five-point Likert scale assessing characteristics related to the three domains. Twenty-three students responded to the survey. The second class (n=9) rated their growth higher in all three domains compared to the inaugural class (n=14). The inaugural class utilized the faculty mentor the most (11/14, 78.6 %). The second class utilized the on-site peer mentor the most (9/9, 100 %). Qualitative data analysis led to the emergence of three themes: (1) students utilizing their faculty mentor had the greatest growth in PPD and ET; (2) students utilizing on-site peer mentorship reporting the greatest growth in SR; and (3) informal peer mentorship utilization correlating with less growth in the three domains. Our study demonstrates the profound impact that mentorship has on growth in the three domains regardless of the type of mentorship utilized. The benefits, specifically with regard to SR, of an on-site peer mentorship program may not have been satisfied by other sources of mentorship.

Mapping Proximity to Infectious Disease Physicians Across the United States.

Enduring shortages of infectious disease physicians across the United States continue despite efforts to mitigate the problem. The recent fellowship match results underscore the difficulty in rectifying that shortage. Our report sheds light on the current geographic distribution of US infectious disease physicians and highlights the challenges faced by rural communities.

Factors associated with plans for early retirement among Ontario family physicians during the COVID-19 pandemic: a cross-sectional study

BackgroundHigher numbers of family physicians (FPs) stopped practicing or retired during the COVID-19 pandemic, worsening the family doctor shortage in Canada. Our study objective was to determine which factors were associated with FPs’ plans to retire earlier during the COVID-19 pandemic.MethodsWe administered two cross-sectional online surveys to Ontario FPs asking whether they were “planning to retire earlier” as a result of the pandemic during the first and third COVID-19 pandemic waves (Apr-Jun 2020 and Mar-Jul 2021). We used logistic regression to determine which factors were associated with early retirement planning, adjusting for age.ResultsThe age-adjusted proportion of FP respondents planning to retire earlier was 8.2% (of 393) in the first-wave and 20.5% (of 454) in the third-wave. Planning for earlier retirement during the third-wave was associated with age over 50 years (50–59 years odds ratio (OR) 5.37 (95% confidence interval (CI):2.33–12.31), 60 years and above OR 4.18 (95% CI: 1.90-10.23)), having difficulty handling increased non-clinical responsibilities (OR 2.95 (95% CI: 1.79–4.94)), feeling unsupported to work virtually (OR 1.96 (95% CI: 1.19–3.23)) or in-person (OR 2.70 (95% CI: 1.67–4.55)), feeling unable to provide good care (OR 1.82 (95% CI: 1.10–3.03)), feeling work was not valued (OR 1.92 (95% CI: 1.15–3.23)), feeling frightened of dealing with COVID-19 (OR 2.01 (95% CI: 1.19–3.38)), caring for an elderly relative (OR 2.36 (95% CI: 1.69–3.97)), having difficulty obtaining personal protective equipment (OR 2.00 (95% CI: 1.16–3.43)) or difficulty implementing infection control practices in clinic (OR 2.10 (95% CI: 1.12–3.89)).ConclusionsOver 20% of Ontario FP respondents were considering retiring earlier by the third-wave of the COVID-19 pandemic. Supporting FPs in their clinical and non-clinical roles, such that they feel able to provide good care and that their work is valued, reducing non-clinical (e.g., administrative) responsibilities, dealing with pandemic-related fears, and supporting infection control practices and personal protective equipment acquisition in clinic, particularly in those aged 50 years or older may help increase family physician retention during future pandemics.

How early clinical experiences in rural communities influence student learning about rural generalism considered through the lens of educational theory

Introduction: Rural communities have poorer health compared to urban populations due partly to having lesser healthcare access. Rural placements during medical education can equip students with the knowledge and skills to work in rural communities, and, it is hoped, increase the supply of rural physicians. It is unclear how students gain knowledge of rural generalism during placements, and how this can be understood in terms of place-based and/or sociocultural educational theories. To gain insight into these questions we considered the experiences of pre-clerkship medical students who completed two mandatory four-week rural placements during their second year of medical school. Methods: Data was collected using semi-structured interviews or focus groups, followed by thematic analysis of the interview transcripts. Results: Rural placements allowed students to learn about rural generalism such as breadth of practice, and boundary issues. This occurred mainly by students interacting with rural physician faculty, with the effectiveness of precepting being key to students acquiring knowledge and skills and reporting a positive regard for the placement experience. Discussion: Our data show the central role of generalist physician preceptors in how and what students learn while participating in rural placements. Sociocultural learning theory best explains student learning, while place-based education theory helps inform the curriculum. Effective training and preparation of preceptors is likely key to positive student placement experiences.

Registrars' experience with research in family medicine training programmes in South Africa.

Completion of a research assignment is a requirement for specialist training in South Africa. Difficulty with completion delays graduation and the supply of family physicians. The aim of this study was to explore the experience of registrars with their research in postgraduate family medicine training programmes. An explorative descriptive qualitative study. Extreme case purposive sampling selected registrars who had and had not completed their research on time, from all nine training programmes. Saturation was achieved after 12 semi-structured interviews. The framework method was used for data analysis, assisted by ATLAS.ti software. The assumption of prior learning by teachers and supervisors contributed to a sense of being overwhelmed and stressed. Teaching modules should be more standardised and focussed on the practical tasks and skills, rather than didactic theory. Lengthy provincial and ethics processes, and lack of institutional support, such as scholarly services and financial support, caused delays. The expertise of the supervisor was important, and the registrar-supervisor relationship should be constructive, collaborative and responsive. The individual research experience was dependent on choosing a feasible project and having dedicated time. The balancing of personal, professional and academic responsibilities was challenging. Training programmes should revise the teaching of research and improve institutional processes. Supervisors need to become more responsive, with adequate expertise. Provincial support is needed for streamlined approval and dedicated research time.Contribution:The study highlights ways in which teaching, and completion of research can be improved, to increase the supply of family physicians to the country.

The state of emergency medicine in Greece: at critical momentum

Greece is a parliamentary republic in southeastern Europe populated by over 10 million permanent residents: 9 million reside on the mainland, with almost 4 million in the greater Athens area. The remaining 1 million populate the over 1200 Greek islands. In addition, more than 160,000 asylum-seekers reached Greece in 2022, and more than 25 million tourists have visited Greece in the last two years. Modern Greek Emergency Medicine (EM) is now in its 4th decade. The Greek government has focused the last few years on enhancing the quality of emergency services provided in public hospitals. Emergency Departments (EDs) are being modernized, undergraduate medical education gradually incorporates EM, and a specialty training program in emergency nursing has been established. However, the late recognition of the critical importance of EM as a specialty in Greece has resulted in the subsequent need to create three alternative pathways to EM, none of which are direct from residency. The first is a 24-month Emergency Medicine fellowship after completing a residency in another specialty and then passing the national exam. The second is for physicians who have worked in a public hospital ED (Gr: Ethniko Systima Ygeias (ESY) ESY for at least three years and successfully passed the national exam. The third, which no longer exists, is a ‘grandfather’ pathway for those physicians who worked in an ESY ED for five years prior to the creation of the fellowship training program. As a result, there is a critical shortage of EM-trained physicians, resulting in most care being provided by physicians without formal training in EM. This is further confounded by the country’s challenging geography, with frequent air transfers from the islands to mainland hospitals. Creating an EM Residency training program is a critical next step to overcoming many of the challenges facing EM provision in Greece today: it would address the shortage of EM-trained providers, decrease the need for costly ground and air transfers, and improve the quality of emergency care throughout Greece.

An Analysis of American Urological Association Census Trends: Earlier Planned Retirement and Practice Pattern Changes May Exacerbate the Urology Workforce Shortage

ObjectiveTo explore how changes in planned retirement age, practice setting, and physician productivity may impact the workforce shortage in urology. MethodsWe compared data between the 2015 and 2022 American Urological Association census, a specialty-wide annual survey which collects data on demographics, practice patterns and procedures from a representative sample of US urologists. Workforce productivity was measured by the self-reported number of hours worked per week and patients seen per week. A novel formula was developed to demonstrate how planned retirement age and productivity impact the workforce’s production capacity. ResultsThe total number of practicing urologists increased during the period from 2015 to 2022 (11,990 to 13,976), while the mean age of practicing urologists decreased slightly (55.0 to 54.5 years; p <0.002). During this period, the mean planned age of retirement for all urologists decreased from 68.9 years to 67.7 (p <0.001). Urologists in solo practice had a significantly higher planned age of retirement at 71.9 years (p <0.001) as compared to all other practice models. The number of patients seen per week for all urologists decreased from 78.7 to 72.9 (p <0.001). The amount of hours worked per week remained relatively constant between the study periods. The maximum possible number of patients seen by the workforce prior to retirement increased by only 2.4% during the study interval. ConclusionThough the US urology workforce is growing and the mean age is decreasing, decreases in planned retirement age and productivity may offset these gains and intensify the physician shortage for US urologists.

Investigating the perceptions of career development as the Japanese regional quota medical students and graduates in Aprefecture.

There are few reports about the perceptions of the regional quota called Chiikiwaku medical students and graduates. Eighty-four medical students and 41 graduates were enrolled in A prefecture. The questionnaire comprised 22 items scored on a 7-point Likert scale, focusing on perceptions of merit and demerit of Chiikiwaku. The data were collected online. Chiikiwaku students scored higher on an item such as 'regional quotas are a solution to the doctor shortage'. Chiikiwaku graduates felt more burdened than Chiikiwaku students. Our results suggested that the perception of Chiikiwaku was different between Chiikiwaku students and graduates.

Dealing with the doctor shortage: a qualitative study exploring French general practitioners' lived experiences, difficulties, and adaptive behaviours.

The shortage of general practitioners (GPs) is a growing concern in Europe, especially in France. This problem is likely to continue until the end of the 2020s. To study the GPs' perceptions of access to care in medically underserved areas (i.e. with low physician density), its consequences on their working conditions, and how they cope with the resulting difficulties. Semi-structured individual interviews were conducted between May and August 2021 of 29 GPs practising in areas of southeastern France with a low physician density or at risk of a doctor shortage. Purposive sampling was used to include profiles of diverse physicians and diverse rural and urban areas. The interviews, conducted with an interview guide, were transcribed and analysed thematically. The participants described a serious degradation of access to care in their areas. These issues also concerned urban areas, where they were, according to the participants, underrecognized. The participants' workloads were rising, at a rate often perceived as unsustainable: many participants, including the youngest group, reported they were exhausted. Their principal source of dissatisfaction was their impression that they could not do their work correctly. Participants reported that these difficulties required them to improvise and adapt without any official or formal method to keep their practice manageable. These GPs were worried about the future of their profession and their patients. They expected strong measures by public policymakers and officials, but paradoxically seemed to have little interest in the solutions these officials are promoting.

How the training pathways and capacity of rural physicians inform their scope of practice: A qualitative study examining the experiences of Australian and international medical graduates in South-East New South Wales, Australia.

Current strategies to address shortages of rural doctors focus on developing a pipeline for rural generalist practice. Limited research has explored how doctors' professional journey engenders the skills required to practice rurally. This paper analyses how rural general practitioners' clinical pathway informs their scope of practice and future retention. Qualitative thematic analysis using semi-structured telephone interviews. Twenty-one general practitioners appointed in their local health district of Murrumbidgee and Southern New South Wales, Australia, within the past 10 years. Participants comprised 10 Australian medical graduates (AMG) and 11 international medical graduates (IMG). AMGs and IMGs contrasted how their pathway into rural practice, and capacity to work rurally, informed their scope of practice. Australian medical graduates' familiarity with rural areas was consolidated through congruous experiences, including at rural clinical schools. Paradoxically, the fluency of their training limited the amount of unsupervised experience and confidence AMGs gained. Together with a focus on work-life balance, this limited many to providing mainstream general practice, precluding extending their scope of practice. International medical graduates described disseminated experiences, often unsupervised in high-volume contexts. However, a lack of professional opportunities prevented them from extending their scope of practice. IMG and AMG motivation and pathway for working rurally differ. Respective cohorts have concerns regarding requisite skills and knowledge for rural practice, which incorporates opportunity and recognition. Entry points for training should be variable to allow consideration of life stage, prior skill development and extension of scope of practice. Doctors' scope of practice is informed by their pathways into rural practice. Australian medical graduates may not gain adequate competence during expedited training programs to confidently undertake extended clinical activities. International medical graduates, however lacked the opportunities and support, to utilise their expertise in rural practice. Complementarily utilising the expertise and commitment of both AMGs and IMGs may synergistically address workforce shortages.

South African midwife specialists' experiences in the utilisation of their knowledge and skills.

Midwifery specialisation was introduced in 1993 as a response to escalating maternal and neonatal mortalities and shortage of physicians in rural parts of South Africa. Basic midwives enrolled into a postgraduate midwifery qualification to extend their knowledge and skills which enabled them to manage complicated obstetric conditions. The postgraduate midwifery qualification rendered them midwife specialists upon completion of the course. Yet, MS remain underutilised in clinical facilities due to limiting practice regulations and fear of medico-legal litigations, leading to forfeiture of skills. The study aimed to explore and describe midwife specialist' experiences of optimal utilisation of their knowledge and skills in public health facilities in South Africa. Public health facilities based in seven provinces in South Africa where MS were employed, formed part of the research setting. A qualitative, descriptive and explorative research design was followed using phenomenological approach. Sixteen purposefully sampled midwife specialists participated in four focus group interviews. Data were analysed using Collaizi's descriptive method. Three themes, each with categories, were derived from the data. Research results confirmed midwife specialist' limited utilisation of knowledge and skills in public facilities. This was associated with the existing practice regulations, restricting midwife specialists to basic midwifery roles. The lack of practice regulations, particularly for midwife specialists hinders optimal utilisation of their knowledge and skills in the public health facilities. This study highlighted midwife specialist' barriers in optimally embracing their expert knowledge and skills. Barriers may guide formulation of strategies to facilitate midwife specialist' knowledge and skills utilisation.

Developing interconnectedness is critical in retaining rural general practitioners: A qualitative thematic analysis of recently recruited general practitioners to South East New South Wales, Australia.

Australia, in common with many countries globally, has a shortage of doctors working rurally. Whilst strategies and current research focus on recruitment, attrition from rural practice is a significant determinant of such shortages. Understanding doctors' decisions to stay or leave, once recruited, may provide further insights on how to address this rural differential. This study comprises a qualitative study of 21 recently recruited nationally-trained doctors and international medical graduates to a rural area of New South Wales, Australia. Interviews focused on their experiences prior to and within rural practice, and how these influenced their future career intentions. We used reflexive thematic analysis with each interview coded by two researchers to build an explanatory framework. Our findings comprise five themes which applied differentially to nationally-trained doctors and international medical graduates: connectedness across professional, personal and geographic domains, how multi-faceted connectedness was, and dissonance between participants' expectations and experiences. Amongst nationally-trained doctors, connectedness stemmed from prior rural experiences which engendered expectations founded upon their ability to develop community-level relationships. Experiences were mixed; some described difficulties maintaining a boundary between their personal and professional lives, which encroached upon their ability to embed within the community. International medical graduates' expectations were cultivated by their pre-conceptions of Australian postgraduate training but they lamented a lack of professional opportunities once in practice. Moreover, they described a lack of professional relationships with local, nationally-trained, doctors that could help them embed into rural practice. This study highlighted that when connectedness occurs across professional, geographic and personal domains doctors are more likely to continue rural practice, whilst illustrating how the importance of each domain may differ amongst different cadres of doctor. Supporting such cadres develop supportive interrelationships may be a low hanging fruit to maximise retention.

Setting the Target: Comparing Family Medicine Among US Allopathic Target Schools.

Despite the persistent primary care physician shortage over 2 decades of allopathic medical school expansion, some medical schools are absent a department of family medicine; these schools are designated as "target" schools. These absences are important because evidence has demonstrated the association between structured exposure to family medicine during medical school and the proportion of students who ultimately select a career in family medicine. In this study, we aimed to address part of this gap by defining and characterizing the current landscape of US allopathic target schools. We identified allopathic target schools by reviewing all Liaison Committee of Medical Education (LCME) accredited institutions for the presence of a family medicine department. To compare these schools in terms of family medicine representation and outcomes, we curated descriptive data from publicly available websites, previously published family medicine match results, and school rankings for primary care. We identified 12 target schools (8.7% of all US allopathic accredited medical schools) with considerable heterogeneity in opportunities for family medicine engagement, leadership, and training. Target schools with greater family medicine representation had increased outcomes for family medicine workforce and primary care opportunities. With growing primary care workforce gaps, target schools have a responsibility to enhance family medicine presence and representation at their institutions. We provide recommendations at the institutional, specialty, and national level to increase family medicine representation at target schools, with the goal that all schools eventually establish a department of family medicine.