Shortage Of Physicians Research Articles

MIDWIFERY IN BRITISH COLUMBIA: IS IT TIME FOR AN EXPANDED SCOPE OF PRACTICE? FINDINGS FROM A QUESTIONNAIRE ON PRACTICE ISSUES IN BRITISH COLUMBIA

Canada is currently facing a shortage of physicians providing maternity care in both urban centres and rural environments. Although midwives have been regulated in five Canadian provinces, they are currently unable to meet the needs of a diversity of childbearing women. An expanded scope of practice may address some of the current obstacles to the provision of care. A 145-item questionnaire on current practice issues faced by midwives in British Columbia was administered to all registered midwives in the province in March 2002 (n=65). Thirty-five questionnaires were returned for a response rate of 54%. One component of the questionnaire focused on respondents' views of an expanded scope of practice. Out of a possible 32 items, the majority of respondents advocated including an additional 17 items into their current scope of practice. Desired functions included increased prescribing authority and an increase in some technical skills. Conversely, the majority of respondents were not interested in including15 additional items including gynecological surgery and advanced procedures. In order to be a viable long-term contributor to maternity care in Canada, midwives must engage in a dialogue with each other over future directions for their profession, begin consultations with other players in maternity care, and develop a mechanism for evaluating any changes to their scope of practice. The results of this study indicate an interest on the part of some midwives to increase their scope of practice. However, findings may not be representative of the opinions and attitudes of all registered midwives in British Columbia. More research is needed into the nature and implications of such changes.

The supply and demand for rehabilitation health workforce in Saudi Arabia.

Adequate supply of rehabilitation health workforce is a prerequisite for enhancing access to rehabilitation care. However, there is a lack of comprehensive data regarding the supply of rehabilitation health workers in Saudi Arabia. To determine the need for, and supply of, rehabilitation workforce, and investigate the relationship between rehabilitation workforce supply and rehabilitation needs in Saudi Arabia. This cross-sectional study measured the ratio of physiotherapists and occupational therapists per 10 000 population. Data were obtained from the Ministry of Health, family health survey and census data of the General Authority for Statistics and published literature. To assess the need for rehabilitation services, we computed a composite disability index based on 3 variables: count of individuals with physical disabilities, those with chronic diseases, and those aged > 65 years. Determinants of the supply potential were population size, rural population percentage, and physician supply. Data were analysed using descriptive statistics and simple linear regression. The ratios of physiotherapists and occupational therapists working at the Ministry of Health facilities were 0.69 and 0.03 per 10 000 population, respectively. Overall rehabilitation health workforce ratio was 0.73 per 10 000. Supply varied across regions, from 0.4 for Riyadh to 2.5 for Al Jouf. Nine regions exceeded the overall ratio. Rehabilitation need index ranged from 0.144 in Najran to 0.212 in Aseer. No significant associations were found between rehabilitation workforce supply on one hand, and need and other potential determinants on the other hand. The rehabilitation workforce supply in Saudi Arabia surpassed the regional and global averages, but was lower than the average for high-income countries. Workforce distribution varied by region across the country and was not related to need. It is important to consider the need for rehabilitation services and context-specific factors when determining the optimal size and distribution of the rehabilitation health workforce in Saudi Arabia.

Demographic and Systemic Risk Factors for Persistent Corneal Edema Following Cataract Surgery in Patients With and Without Diabetes

PurposeTo identify risk factors associated with the development of corneal edema (CE) and the need for corneal transplantation following cataract surgery. DesignRetrospective cohort study. MethodsSetting: Nation-wide sample of Medicare beneficiaries from 2011-2015. Study PopulationMedicare beneficiaries aged over 65 years who received cataract surgery between 2011-2014 with at least 1 year of continuous follow-up. Data was retrieved from the Denominator and Physician Supplier Part B file from the Center for Medicare and Medicaid Services. Main Outcome(s) and Measure(s)The main outcome was the association between demographic characteristics (e.g. age, sex, race/ethnicity) and systemic factors including diabetes status, hypertension, and tobacco use on the incidence of CE and the subsequent need for corneal transplantation following cataract surgery. ResultsAmong 187,746 beneficiaries, 67,734 had diabetes and 120,012 did not. Beneficiaries with diabetes were more likely to develop CE compared to those without (Odds ratio [OR] 1.19, 95% Confidence Interval [CI] [1.02-1.40]). Compared to those aged 65-74, beneficiaries aged 75-84 and over 85 were more likely to develop CE (OR 1.29 [1.09-1.52]) and OR 1.96 [1.55-2.46], respectively). Asian (OR 2.42 [1.66-3.40]), Hispanic (OR 2.60 [1.73-3.74]), and North American Native (OR 3.59 [1.78-6.39]) race was associated with increased likelihood of developing CE. North American Native beneficiaries had higher risk of requiring corneal transplantation compared to White beneficiaries (OR 9.30 [2.26-25.31]). Female sex decreased likelihood of requiring corneal transplantation post-operatively (OR 0.56 [0.36-0.87]). Amongst those with diabetes, the presence of proliferative diabetic retinopathy increased the likelihood of developing CE (OR 1.94 [1.05-3.39]). ConclusionOlder age, diabetes, and non-White race elevate the risk of CE following cataract surgery, with race incurring the highest risk. Further research is needed to understand the factors underlying the significantly increased risk of CE in racial and ethnic minorities within the United States.

Emerging Trends in the Prevalence of Military Medicine Interest Groups and Specialty Tracks at U.S. Medical Schools.

A challenge confronting health care is the national physician shortage, notably impacting the DoD's recruitment of military physicians. To address this, the Health Professions Scholarship Program is annually awarded to medical students to facilitate their transition into the U.S. Armed Forces. There is a glaring absence of military medical education in civilian schools to accommodate the unique interests of these students. While medical schools have adapted with interest groups and specialty tracks, the current presence of military medicine interest groups (MMIGs) and military medicine specialty tracks (MMSTs) remains under-explored. This study aimed to (1) update the prevalence of MMIGs in U.S. medical institutions, (2) identify the presence of MMSTs, and (3) compare military medicine involvement between allopathic and osteopathic programs. The study was approved for exempt status from the Kansas City University Institutional Review Board (study number 20,211,568-1). In a cross-sectional analysis, surveys were sent to 208 U.S. medical schools, with responses from student services or available public data from 200 institutions included in the final analysis. A secondary survey was sent to respondents who provided MMIG or MMST contacts. Results indicated that 62% (n = 124/200) of schools currently have an established MMIG, a modest growth from 56% (n = 70/125) in 2015 (p = .14). MMST prevalence, however, is minimal at 2.5% (5/200). Osteopathic institutions demonstrated a significantly greater engagement in military medicine education (88.7%) compared to allopathic schools (52.4%) (p < .001). This research underscores the need for comprehensive military medical training in medical schools to meet the interests and career aspirations of their students. Future studies should also evaluate the efficacy of MMIGs and MMSTs in preparing students for military medical roles.

Perceived Effectiveness of a Surgical High School Outreach Program on Career Trajectory of Underserved High School Students

Background: The United States faces a significant physician shortage, projecting a need for 52,000 more primary care doctors by 2025.1 Underserved communities are disproportionately affected by this shortage. With underrepresented minority healthcare providers being significantly more likely to practice in underserved communities, it is essential to increase diversity in medicine.2–4 High school outreach programs introducing teenagers from minority populations to the medical field may increase availability of healthcare in socioeconomically disadvantaged areas. Our goal was to determine whether participants in the Urology High School Outreach Program experienced increased interest in pursuing a career in medicine, or STEM-related fields after receiving mentorship and exposure to the medical field. Methods: 138 underserved high school students participating in a one-day Urology High School Outreach Program (HSOP) took a pre-survey prior to a physician-led lecture, and five urology-related surgical techniques workshop stations, led by medical students. The sessions culminated with a Q&amp;A panel with the medical students, followed by the post-survey. Results: Of the 138 students that participated in the pre-survey, 110 students (79.7%) answered the post-survey. Analysis of these survey responses revealed that the Urology HSOP predominantly served a demographic consisting of Hispanic (39.1%) and Asian (32.7%) backgrounds. Question One, pertaining to the likelihood of pursuing a career in healthcare, saw a statistically significant average increase of 0.11 out of 5 (p=0.014). Question Two, pertaining to the likelihood of pursuing a career in STEM, saw the largest significant average increase of 0.34 out of 5 (p&lt;0.00001). Question Three, pertaining to interest in developing new technology, saw a statistically significant average increase of 0.28 out of 5 (p=0.001). Conclusion: In summary, a significant increase in interest towards STEM and medicine careers emerged among Urology High School Outreach Program participants. Further investigation is warranted to ascertain whether these changes are limited to the underrepresented demographic, or extend to all program participants.

Dermatology workforce projections in the United States, 2021 to 2036.

There has been a growing imbalance between supply of dermatologists and demand for dermatologic care. To best address physician shortages, it is important to delineate supply and demand patterns in the dermatologic workforce. The goal of this study was to explore dermatology supply and demand over time. We conducted a cross-sectional analysis of workforce supply and demand projections for dermatologists from 2021 to 2036 using data from the Health Workforce Simulation Model from the National Center for Health Workforce Analysis. Estimates for total workforce supply and demand were summarized in aggregate and stratified by rurality. Scenarios with status quo demand and improved access were considered. Projected total supply showed a 12.45% increase by 2036. Total demand increased 12.70% by 2036 in the status quo scenario. In the improved access scenario, total supply was inadequate for total demand in any year, lagging by 28% in 2036. Metropolitan areas demonstrated a relative supply surplus up to 2036; nonmetropolitan areas had at least a 157% excess in demand throughout the study period. In 2021 adequacy was 108% and 39% adequacy for metropolitan and nonmetropolitan areas, respectively; these differences were projected to continue through 2036. The findings suggest that the dermatology physician workforce is inadequate to meet the demand for dermatologic services in nonmetropolitan areas. Furthermore, improved access to dermatologic care would bolster demand and especially exacerbate workforce inadequacy in nonmetropolitan areas. Continued efforts are needed to address health inequities and ensure access to quality dermatologic care for all.

In-State Retention Rates of Female Neurosurgery Graduates

We sought to determine the rate of retaining female neurosurgery graduates in the same states as their medical education and identify medical school and state characteristics associated with high retention rates. Database from the Centers for Medicare & Medicaid Services was used to extract female physicians indicating "neurosurgery" as their specialty. The top 25 medical schools with the highest number of female neurosurgery graduates were selected. Descriptive analysis was used to determine the retention rate of female neurosurgery graduates. Univariable and multivariable analyses were used to identify medical school and state characteristics associated with high retention rates. Medical schools with the highest retention rate included the University of California, San Francisco (60%), the University of Alabama (60%), and the University of Pennsylvania (60%). Univariable and multivariable analysis showed the number of female neurosurgery attendings (β=0.036, 95% confidence interval [CI]=0.003 to 0.070, P=0.04 and β=0.036, CI=0.001 to 0.071, P=0.04.) and the healthcare employment rate (β=0.098, CI=0.011 to 0.186, P=0.03 and β=0.117, CI=0.021 to 0.212, P=0.02) to be positively associated with the retention rate of female neurosurgery graduates. Retaining female neurosurgery graduates within a state is essential for addressing the physician shortage and gender inequality. To encourage female medical students to practice in the same state, medical schools and states should work collectively to improve the visibility of female neurosurgeons and increase employment opportunities.

Assessing metabolic risk factors for psychiatric patients: An IT-supported task shift from physician to pharmacist

BackgroundPsychiatric medication can have adverse effects such as weight gain, which is a metabolic risk factor for the development of cardiovascular disease and diabetes. This study aimed to assess whether an IT-supported task shift from physicians to pharmacists could improve clinical guideline compliance in assessing metabolic risk factors for psychiatric patients. MethodAn IT tool was designed and implemented in the electronic health record to enable pharmacists to efficiently screen patients for metabolic risk factors. The tool provided a risk score for each patient based on criteria from the cross-regional guideline. All admitted patients with a score were assessed by the pharmacists, who referred and discussed the patients with a physician when deemed relevant. We measured guideline compliance during baseline (manual screening) and intervention (automated screening) after implementing the IT tool and pharmacist assessment. After the intervention period, we conducted follow-up interviews with all participating pharmacists. ResultsGuideline compliance increased significantly from 26 % (baseline) to 63 % (intervention) (Fisher’s exact test p < .001, N = 98). The task shift from physicians to pharmacists was also significant (Fisher’s exact test, p < .001, N = 40). Interviews revealed that the pharmacists found the task shift meaningful and received positive feedback from the physicians. The facilitators of the task shift included interprofessional collaboration, physician shortage, provider empowerment, and the manageable nature of the task. The barriers included a need for further competence development and lack of pharmacist authorization. The IT tool was considered useful and suggestions for improvements emerged. ConclusionThe IT-supported task shift from physician to pharmacist significantly improved guideline compliance in the assessment of metabolic risk factors in psychiatric patients. The findings support increasing the pharmacist’s role in psychiatric care to improve patient outcomes.

Addressing the doctor shortage and assisting women physicians: a win-win

Addressing the doctor shortage and assisting women physicians: a win-win

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.

Self-Reported Panel Size Among Family Physicians Declined by Over 25% Over a Decade (2013-2022).

Underinvestment in primary care and erosion of the primary care physician workforce are resulting in patients across the US experiencing growing difficulty in obtaining access to primary care. Compounding this access problem, we find that the average patient panel size among US family physicians may have decreased by 25% over the past decade (2013 to 2022). Reversing the decline in access to primary care in the face of decreasing panel sizes requires both better supporting family physicians to manage larger panels, such as by expanding primary care teams, and substantially increasing the supply of family physicians.

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.

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.

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.

The Cost of a Locum: A Simulation to Determine When You Are Paying Too Much for Your Anesthesia Locum Tenens Coverage.

Current research on locum tenens physicians has primarily focused on their safety, reliability, and patient outcomes, leaving a significant gap in understanding the financial implications of their employment in health systems. Amidst a persistent shortage of physicians across specialties, healthcare organizations have increasingly relied on locum tenens to meet the rising demand for clinical services. This study aims to bridge the knowledge gap by evaluating the financial feasibility of employing locum tenens physicians compared to full-time anesthesiologists, given the context of growing physician shortages and increasing healthcare demands. We developed a Python simulation model to compare the costs of hiring locum tenens versus full-time anesthesiologists. The model inputs included hourly rates for both locum tenens and full-time anesthesiologists and the upfront hiring costs for full-time physicians. By plotting these costs against each other, the model identifies the breakeven point: the number of working hours at which the cost of employing a locum tenens physician equals that of hiring a full-time physician. Utilizing Monte Carlo simulations with data from the Northeastern United States, we assessed the variability and determined an average breakeven point across different scenarios. The Monte Carlo simulation, based on 10,000 iterations, revealed an average breakeven point of 665 hours, corresponding to just over 11 weeks of 60-hour workweeks. This suggests that for any locum tenens engagement exceeding this duration, hiring a full-time anesthesiologist becomes more cost-effective for the healthcare institution. The simulation also showed that 28% of scenarios had a breakeven point below 60 days, highlighting the financial dynamics and decision-making complexities in employing locum tenens versus full-time physicians. The findings indicate that employing locum tenens physicians for durations shorter than 665 hours remains financially viable compared to the option of hiring full-time anesthesiologists. However, the significant variability observed in the simulations underscores the importance of context in making staffing decisions. Healthcare organizations must consider the specific needs and circumstances of their operations when deciding between hiring locum tenens and full-time physicians, especially for longer-term coverage requirements.

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.