Shortage Of Physicians Research Articles

Supply and Geographic Distribution of Geriatric Physicians and Geriatric Nurse Practitioners

ImportanceThe rapidly growing population of older adults and their concomitant high prevalence of chronic health conditions require an increased supply in the specialized geriatric workforce to meet increasing health care demands. Understanding trends and geographic disparities in the supply of the geriatric workforce is essential for developing effective policies.ObjectivesTo examine temporal and geographic trends in the supply of geriatric physicians (GMDs) and geriatric nurse practitioners (GNPs) from 2010 to 2020 and to assess potential disparities between metropolitan and nonmetropolitan counties.Design, Setting, and ParticipantsThis repeated cross-sectional study used annual county-level data from 2010 to 2020, encompassing all counties in the 50 US states and Washington, DC. Statistical analysis was performed from June 2023 to March 2024.Main Outcomes and MeasuresThe primary outcomes were the numbers of GMDs, GNPs, and the combined number of GMDs and GNPs per 100 000 older adults. The secondary outcome included the proportion of counties with or without any GMDs or GNPs.ResultsFrom 2010 to 2020, the national per capita supply of GMDs decreased by 12.7%, from 13.4 per 100 000 older adults in 2010 to 11.7 per 100 000 older adults in 2020, while GNPs increased by 125.0%, from 4.4 per 100 000 older adults in 2010 to 9.9 per 100 000 older adults in 2020. The combined GMD and GNP workforce increased by 21.3%, from 17.8 per 100 000 older adults in 2010 to 21.6 per 100 000 older adults in 2020. The distributions of older adults, GMDs, and GNPs closely resembled the distribution of metropolitan and nonmetropolitan counties, with GMDs and GNPs highly concentrated in metropolitan counties where the number of older adults was greatest. Throughout the study period, 63.9% of counties (2008 of 3142 in 2010-2019; 2009 of 3143 in 2020), predominantly small and nonmetropolitan counties, had no GMDs or GNPs, which was associated with the disparities between metropolitan and nonmetropolitan counties.Conclusions and RelevanceThis repeated cross-sectional study found that from 2010 to 2020, the overall national supply of GMDs and GNPs kept pace with the growth of the older population, largely due to the rapid growth in the number of GNPs. However, significant geographic disparities persisted, particularly in small and nonmetropolitan counties. Future efforts should focus on increasing the availability of GMDs and GNPs in underserved small and nonmetropolitan counties to ensure equitable access to geriatric care.

Gauging Medical Students' Interests in Infectious Diseases.

Infectious diseases is a crucial specialty in medicine, yet applications for fellowship have declined even as the United States faces an imminent shortage of infectious disease physicians. Career interests often develop in medical school, but little is known about which interests and experiences are associated with interest in ID. Evaluate interest in ID among medical students and identify factors associated with interest and disinterest in ID careers. We developed a 26-question survey to gauge interest in infectious diseases (ID). All 16 medical schools in Texas were contacted and invited to participate. A total of 262 students across 9 medical school campuses completed the survey. Those interested in ID as a career had a significantly higher interest in public health (p<0.0001) and global (p<0.0003) health. The presence of an ID campus interest group (p<0.0015) and direct experience with the ID profession (p<0.0001) were also associated with interest. The most common reasons for lack of interest were lack of interest in pursuing internal medicine or pediatric residency, lack of compensation, and lack of procedures. Those interested in ID expressed interest in a wide variety of career pathways within ID, the most common being general inpatient and outpatient ID, as well as medical microbiology and global health/tropical medicine/travel medicine. Based on this survey, recruitment efforts for new ID fellows might include focusing on students with interests in public and global health, as well as increasing direct exposure to ID at the medical school level.

Addressing Physician Shortage in Hawai'i - Kaua'i Medical Training Opportunities.

Addressing Physician Shortage in Hawai'i - Kaua'i Medical Training Opportunities.

The evaluation of an eHealth tool to prevent and alleviate migraine complaints in adults

Abstract Background Migraines attacks cause great suffering in individual patients. There is great unfulfilled potential to increase patients’ knowledge about various personal triggers and subsequent treatments. The objective of this study is to pilot test an e-Health tool that aims to increase migraine patients’ knowledge. It takes into account personal preferences and contributes to informed decision-making in choosing the appropriate method. Considering the shortage of primary care physicians and other health care providers, such an e-Health tool could be of great value. Methods lessmigraine.nl consists of a website with information plus an electronic decision aid. It was evaluated on its content, development process and effectiveness, and its contribution to the patients’ empowerment process. A first round of usability testing was done using semi-structured interviews and thematic analysis with 12 patients from a Dutch General Practice until data saturation. After minor improvements to the e-tool, in a first implementation step subsequently 85 patients used the e-tool. Results Patients’ expectations were exceeded in terms of the content of the e-Health tool, as all patients discovered new potential migraine triggers. Most patients found the tool effective in the sense that it provided enough information to decide on an appropriate treatment. The implementation was successful in the sense that all 85 participants completed the e-tool. Most important triggers were stress, sleeping problems, changes in weather and flickering or bright light. Conclusions The majority of the migraine patients were satisfied with the e-Health tool. It enlarged their knowledge of prevention and treatment options and therefore empowered them in their decision-making process and communication with their GP. Other aspects of implementation need to be studied. This study needs to be repeated in other clinical settings. Key messages • Migraines cause great suffering in individual patients: Considering the shortage of primary care physicians and other health care providers, an e-Health tool could be of great value. • The e-Health tool increases patients’ knowledge about migraine, including personal triggers and subsequent treatments.

Analysis of medical doctor supply in Bulgaria, Croatia, Romania, and Serbia in the last two decades

Abstract Introduction The shortage of medical doctors in Europe has become a priority issue, especially in the Eastern European region, where many countries are making large investments to ensure adequate supply. Training future medical professionals is a lengthy and costly process that significantly impacts healthcare accessibility and quality. As part of the project of the Laboratory for Strengthening Capacity and Performance of Health System and Workforce for Health Equity, we aimed to assess the changes in the medical doctor supply in several Balkan countries over the last two decades. Methods Data on the total number of graduated medical doctors (MD) and their rate per 100,000 population from 2000 to 2021 was retrieved from the Eurostat database. This open-access database contains the reported number of students who have graduated from medical schools for each year and selected countries (Bulgaria, Croatia, Romania, and Serbia). The standard methods of descriptive statistics were used to perform the analysis. Results During the observed period, the number of MDs graduating annually and their rates per 100,000 population have increased in all countries. Romania leads with the highest rate of MD graduates at 26.18 per 100,000 people, followed by Bulgaria (22.74), Serbia (19.15), and Croatia (16.56). From 2000 to 2021, Bulgaria experienced the highest increase in the number of medical doctor graduates, with a rise of 169.1% in absolute numbers and 200.9% in rate. In contrast, Serbia had the lowest increase, with only a 135.5% rise in the total number of medical doctor graduates and a rate increase of 152.3%. Conclusions In the last 20 years, Bulgaria, Croatia, Romania, and Serbia have seen an increase in the number of MD graduates and their rate per 100,000 population. Policymakers should consider the investments and education trends of medical professionals in relation to their employment and migrations to predict the future supply of doctors in this region. Key messages • Bulgaria, Croatia, Romania, and Serbia have seen an increase in the number of MD graduates and their rate per 100,000 population in the last twenty years. • Considering the trends in the number of newly graduated doctors, policymakers should address additional factors to ensure an adequate supply of medical doctors.

Working conditions in OOH-PC centres in Romania: an interview study with healthcare professionals

Abstract Considering the amplifying primary care workforce shortage, the existing knowledge gaps in out-of-hours primary care delivery (OOH-PC) in Romania, as well as the extreme county-to-county variation in the number of functioning OOH-PC centers across the country, from 0 to 32, we set out to document health workers’ perspectives on existing challenges in after hours primary care. Using a qualitative study design, we conducted semi-structured interviews with a purposive sample of 20 healthcare professionals (HCPs): family doctors and nurses providing clinical services in urban and rural OOH-PC centres, family doctors with coordinating and administrative roles, representatives of professional associations and health authorities, as well as emergency doctors and paediatricians. We examined interview transcripts employing thematic analysis. The data collected and analysed revealed several challenges in the provision of care, including physician shortages, increasing workload, low payments, and an organisational model that lacks coordination with other levels of care and services. The analysis of the interview data identified five key themes related to adverse working conditions in OOH-PC: working hours and shift length, increasing workload and patient influx, obstacles to achieving work-life balance, inconveniences related to OOH centre premises (rest space, security), and insufficient financial compensation for after-hours health service provision. Working conditions in OOH-PC centers in Romania constitute a drawback to after hours primary care service provision. Health workers shortage and extreme variation in the number of functioning centres across the country suggest inconsistencies in the governance of OOH-PC. Improving working conditions to recruit and retain health professionals in OOH-PC, combined with targeted policies to optimise organisation and coordination of OOH-PC with other levels of care are as timely as ever to ensure equitable services to the population. Key messages • Current working conditions in OOH-PC Romania impact negatively the health workforce and lead to uneven access for the population. • Improvements in working conditions, service integration, and organisation model are timely for the alleviation of OOH-PC provision.

Incentives to attract and retain physicians to underserved areas - a case study from Portugal

Abstract Issue Physician shortages in underserved areas are a common challenge for governments and policymakers worldwide, including in Europe. Meanwhile, a knowledge gap exists on effective measures to address the issue. Description According to WHO Europe, one of ten actions to strengthen the healthcare workforce is to develop strategies to attract and retain health workers in rural and remote areas. Portugal faces geographical asymmetries in the distribution of physicians, and difficulties in retaining them in certain areas of the country. This case study seeks to describe and analyse the impact of an incentives package introduced in 2015 that aimed to attract and retain physicians in underserved areas. Financial incentives data was gathered via a national health human resources information system. Non-financial incentives data was reported by health institutions through an online form. Document analysis was conducted to understand the scope of the incentives package and its amendments. Results The incentives package implemented in Portugal effectively deployed physicians to underserved areas, since it led to a fourteen-fold increase in physicians settling in underserved areas. In terms of retention, an average of 59% of the physicians that took up the incentives package are still practicing in the same underserved area. However, the difference between the retention levels of physicians under the incentives package and those not covered is minimal. To further reduce health inequities and achieve universal health coverage, a need exists to review the financial and non-financial incentives to better suit physicians’ needs and expectations, as well as those of the National Health Service. Lessons The incentives package introduced in Portugal makes it clear that flexibility in the design of attraction and retention measures is crucial. It requires a long-term commitment and a recognition that each intervention should be assessed and adapted to local circumstances and context. Key messages • The incentives package introduced in Portugal attracted physicians to underserved areas and led to a fourteen-fold increase in physicians settling in underserved areas. • More than half of the physicians are still practicing in the same underserved health institution but the difference in retention against those not covered by the incentives package is minimal.

Impact of an Inpatient Family Medicine Exposure: Changing Student Perception

Introduction: Currently there is a primary care physician shortage in the United States, and this shortage is expected to worsen into the foreseeable future. In 2023, only 7.5 % of US allopathic graduates entered family medicine (FM) residencies. Opportunities to create increased interest in family medicine as a career choice and address hidden curriculum messages in career choice must be explored to address shortages in family medicine. Methods: A 5-day inpatient experience with family medicine residents on a family medicine inpatient service was implemented during a required third-year core medical student clerkship in family medicine. Students who participated in this clerkship change were invited to complete a survey on how this experience altered their perceptions on the roles of family medicine physicians in inpatient medical care, intrapartum care, and care of the newborn, and how it affected their view of FM as a career choice. Results: Of the eligible students, 34% completed the survey. Participating in the FM inpatient experience significantly enhanced students’ perceptions about the depth of knowledge and skill needed for the specialty, increased students’ respect for the specialty, and contradicted students’ perceptions about the complexity of cases treated in the specialty. Conclusion: Adding an inpatient component to a third-year FM clerkship experience can significantly change the perceptions of medical students about the specialty of FM. Brief inpatient exposure to medical students has an impact on hidden curriculum messaging about family medicine.

HBCUs Are an Undervalued Resource for Addressing the US Physician Shortage

HBCUs Are an Undervalued Resource for Addressing the US Physician Shortage

Reducing readmissions: A business case for US hospitals

The 2010 Patient Protection and Affordable Care Act (ACA) linked acute care hospital reimbursements to quality-of-care measures. While the impact of healthcare quality on service provision is well-documented, the effects of 30-day readmissions on hospital financial performance are less understood. This study examines the relationship between 30-day readmission rates and financial performance in U.S. acute care hospitals from 2010 to 2018 using four financial metrics: operating margin, operating revenue, operating cost, and total margin. Data were sourced from the American Hospital Association (AHA) Annual Survey, Centers for Medicare and Medicaid Services (CMS), Area Health Resource Files (AHRF), and CMS cost reports. Univariate analysis of hospital characteristics was followed by an unbalanced panel regression with hospital and year-fixed effects. Inflation adjustments and controls for HRRP, CMI, managed care penetration, payer mix, physician supply, RN and MD staffing, occupancy, and mortality rates were applied. Increased readmission scores for AMI correlated with higher adjusted operating revenues per patient day (β = $26.86, p ≤ .001), but no significant changes in adjusted operating cost, operating margin, or total margin. Following HRRP implementation, adjusted operating revenue decreased for AMI (β = $425.21, p ≤ .019), HF (β = $229.41, p ≤ .023), and PN (β = $229.41, p ≤ .023). HF readmission scores marginally increased the adjusted operating margin (β = $0.0002, p ≤ .064) with no significant impact on other financial metrics. Pneumonia readmission rates marginally increased the adjusted operating margin (β = $0.0002, p ≤ .064) without significantly affecting other financial measures. The study’s findings highlight the potential financial benefits of reducing readmissions for hospitals. However, it also underscores the importance of developing and implementing broader quality metrics that can provide a more comprehensive evaluation of hospital performance, thereby enhancing the audience’s understanding of the need for a comprehensive evaluation of hospital performance.

US Primary Care WorkforceGrowth: A Decade of Limited Progress, and Projected Needs Through 2040.

Despite efforts to mitigate a projected primary care physician (PCP) shortage required to meet an aging, growing, and increasingly insured population, shortages remain, compounded by the COVID-19 pandemic, growing inequity, and persistent underinvestment. We examined primary care workforce trends over the past decade and revisited projected primary care clinician workforce needs through the year 2040. Using data from the AMA Masterfile and Medical Expenditure Panel Survey (MEPS), we analyzed trends in the number of primary care physicians (PCPs) and in outpatient PCP visits by age and gender over the past decade. We then used the Medicare PECOS and Physician & Other Practitioners datasets to identify nurse practitioners (NPs) and physician assistants (PAs) in primary care. Using these baseline clinician enumerations and projected population growth estimates from the US Census Bureau for the years 2020-2040, we calculated estimated primary care workforce needs by 2040. The effects of aging and population growth and baseline shortages in the primary care workforce call for significant increases in the primary care workforce to accommodate rising demands. Office visits to primary care clinicians are projected to increase from 773,606 in 2020 to 893,098 in 2040. We project a need for an additional 57,559primary care clinicians by 2040. Workforce shortages in primary care continue to expand due to populationaging, growth, and heightened rates of clinicianburnout& egress.

Mid-level healthcare providers: Making a fresh case for modern Indian healthcare.

To compensate for physician shortage, many countries around the world have introduced a cadre of mid-level healthcare providers (MLHPs) into their health systems to shoulder many of the conventional responsibilities of a physician. Besides backing their clinical competence and service quality, evidence and experience on MLHPs also supports their lower turnover and higher rural retention rates. In India, mainstreaming of MLHPs has time and again been met with resistance from organized medicine. We explore a fresh case for MLHPs in India in view of some recent developments and the probable future contours that Indian healthcare is likely to assume. Aided by global precedents, we broaden the rationale for mainstreaming MLHPs, address some common misunderstandings, and describe the conducive emergent legal and policy landscape. We also explain how a possible reorganization of Indian healthcare, highly likely under expanded publicly financed health insurance and value-based healthcare regimes, can warrant greater health workforce differentiation and an expanded role of MLHPs in mainstream healthcare delivery. We also touch upon important political economy considerations, including the need for navigating organized medical opposition, involving medical stakeholders in the MLHP mainstreaming process, autonomous regulation of MLHP professions, streamlining MLHP competencies, and inclusive health financing systems.

Enhancing healthcare delivery: the results of implementing mobile anesthesia teams at Romagna Local Health Authority, Italy

BackgroundHealthcare systems face challenges including physician shortages and the need for cost-effective, accessible services. This study aimed to describe the implementation of itinerant anesthesiologist teams to maintain surgical activities within the Romagna Local Health Authority (AUSL Romagna), Italy.MethodItinerant anesthesiologist teams were implemented at AUSL Romagna from February 2021 to December 2022. Data on surgical waiting lists and activities from before and after the implementation were collected using administrative regional data. Additionally, we conducted a satisfaction survey among participating anesthesiologists. Descriptive statistics were used to compare pre- and post-implementation metrics and to report participants’ satisfaction.ResultsThe project enabled 2034 h of surgical activity in 2021 and 3354 in 2022 across specialties including neurosurgery, breast surgery, interventional cardiology, and pediatric surgery. By 2022, surgical waiting times returned to pre-COVID-19 levels. Survey results from 32 participating anesthesiologists (48.5%) indicated high satisfaction with the program.ConclusionThe implementation of itinerant anesthesiology teams in the AUSL Romagna health system shows promise as a potential solution for improving care delivery and reducing waiting times. However, further research is needed to definitively establish its effectiveness and generalizability to other healthcare settings.

Exploring health worker absenteeism at public healthcare facilities in Chhattisgarh, India.

This study aims to assess the health worker absenteeism and factors associated with it in a high-focus district in Chhattisgarh, India. Human resources for health are among the key foundations to build resilient healthcare systems. Chhattisgarh is a high-focus Indian state with a severe shortage of health care workers, and absenteeism further aggravates the shortage. This study was conducted as a mixed-methods study employing sequential explanatory design. Absenteeism was defined as the absence of health worker in the designated position without a formal leave or official reason in two different unannounced visits. A facility survey across all the public healthcare facilities in Jashpur district, Chhattisgarh, was conducted through random, unannounced visits employing a checklist developed based on Indian Public Health Standards. Twelve participants were purposively sampled and interviewed from healthcare facilities to explore factors associated with absenteeism. Survey data were analysed descriptively, and thematic analysis was employed to analyse qualitative interviews. Among all the positions filled at primary health centre level (n = 339), close to 8% (n = 27) were absent, whereas among the positions filled at community health centre level (n = 285), only 1.14% (n = 4) were absent. Absenteeism was not found in the district hospital. Qualitative interviews reveal that macro-level (geographical location and lack of connectivity), meso-level (lack of equipment and amenities, makeshift health facilities, doctor shortage, and poor patient turnover), and micro-level (unmet expectations) factors contribute to health worker absenteeism. Health worker absenteeism was more at PHC level. Systemic challenges, human resource shortages, and infrastructural shortcomings contributed to health worker absenteeism.

Influencing physician distribution through education: a qualitative study on retention in Japan’s rural hospitals

BackgroundAddressing the shortage of healthcare professionals in rural Japan poses significant challenges. At Sanmu Medical Center, incorporating resident physicians into a general medicine training program has proved effective in retaining them as supervising physicians. This study aims to identify the key factors contributing to the success of such programs.MethodsWe used a qualitative research design to comprehensively understand the factors contributing to physician retention in regional community hospitals in areas with physician shortages. Interviews were conducted with four experienced physicians, including the center director, who participated in the general or family medicine training programs at Sanmu Medical Center. Using a semi-structured questionnaire, we explored the factors influencing physician retention in community-based hospitals experiencing shortages. Two physicians specializing in community medicine conducted a content analysis under the supervision of three experts in community-oriented medical education and qualitative research. This approach helped compare retention factors perceived by physicians and the center director.ResultsContent analysis revealed 10 categories and 47 subcategories. The analysis revealed that “Educational activity” and “Supervising physicians and guidance system” are crucial for physician retention in rural hospitals in Japan. The study highlighted key educational factors contributing to retention: engagement in educational activities led to personal and professional growth, creating a rewarding experience for the physicians. Furthermore, a structured supervising physician system provided essential guidance and mentorship, improving the educational environment. Diverse learning opportunities and protected learning times were identified as critical for fostering a sustainable commitment among physicians to work in rural settings. These findings contribute to existing literature by detailing how structured educational activities and mentorship programs in rural hospital settings can significantly impact physician retention.ConclusionsCommunity-based medical education programs that focus on diverse clinical settings, mentorship, and a supportive work environment can enhance physician retention in rural areas. By fostering such educational and professional environments, healthcare institutions can address physician maldistribution and improve care quality in underserved communities. Our study offers practical insights that can be replicated or adapted by other rural hospitals facing similar challenges. It offers targeted strategies to address the unique challenges faced by female physicians in rural healthcare settings.

Pediatric pain physician workforce: an assessment of supply and demand.

Many youth with pain lack access to pediatric pain expertise. There is a critical shortage of pediatric pain physicians, due partly to a paucity of training programs in Pediatric Pain Medicine. Pain fellowships are Anesthesiology-based and there is no pathway to fellowship training or Pain Medicine board certification for pediatricians. This workforce assessment sought to examine the current state of Pediatric Pain Medicine in the United States and future interest in pursuing Pain Medicine among pediatricians. A multidisciplinary working group of Pain Medicine clinicians designed three surveys to examine pediatric comprehensive pain programs in the US, practice patterns of pediatricians and their motivations and opinions regarding Pain Medicine board certification, and current residents' exposure to and interest in Pediatric Pain Medicine. Wait times for initial evaluations are two months or longer for two-thirds of responding centers, and barriers to increase staff size and resources were reported, including an inadequate number of trained or available physicians. Pediatricians expressed interest in earning board certification in Pain Medicine, given the opportunity. Additionally, there is interest among pediatric residents in pursuing Pediatric Pain Medicine, and qualitative data highlight information residents perceived needing in order to pursue a career in the field. Results demonstrate the need for increased training opportunities in pediatric pain medicine. A formal pathway to Pain Medicine for Pediatricians should be developed to increase the potential workforce and to address the lack of trained pediatric pain specialists, thereby improving access to care for youth with pain.

The Healthcare Workforce Shortage of Nurses and Physicians: Practice, Theory, Evidence, and Ways Forward.

The healthcare sector is ubiquitously plagued by workforce shortages in economies around the globe. The fragility of this structural shortage becomes apparent when external shocks, such as the COVID-19 pandemic, exacerbate the lack of workers in clinical practice. In this article, we summarize current trends in healthcare workforce development across the globe, review theoretical concepts of workforce shortages, and discuss policies to address them. In practice, developed countries often address workforce shortages with targeted migration policies. However, targeted workforce migration policies only intensify workforce shortages in low-and middle-income countries. Theoretical macroeconomic models suggest that supply shortages may result from too low wages, supply lagging behind demand, and social perception. Changes in the wage rate cannot sufficiently increase the supply of health professionals as scholars find inelastic wages for physicians and nurses. Nonpecuniary factors such as working conditions, job satisfaction, and intrinsic motivation are at least equally important as financial incentives. In conclusion, increased wages can only be part of a heterogeneous policy plan to address shortages. Migration and retirement levels of health professionals can temporarily mitigate workforce shortages but rarely change the underlying systemic issues. Increasing the number of places available in medical and nursing schools while also improving, both, financial and nonfinancial incentives for employees are long-term structural policy options.

Navigating Nephrology's Decline Through a GPT-4 Analysis of Internal Medicine Specialties in the United States: Qualitative Study.

The 2024 Nephrology fellowship match data show the declining interest in nephrology in the United States, with an 11% drop in candidates and a mere 66% (321/488) of positions filled. The study aims to discern the factors influencing this trend using ChatGPT, a leading chatbot model, for insights into the comparative appeal of nephrology versus other internal medicine specialties. Using the GPT-4 model, the study compared nephrology with 13 other internal medicine specialties, evaluating each on 7 criteria including intellectual complexity, work-life balance, procedural involvement, research opportunities, patient relationships, career demand, and financial compensation. Each criterion was assigned scores from 1 to 10, with the cumulative score determining the ranking. The approach included counteracting potential bias by instructing GPT-4 to favor other specialties over nephrology in reverse scenarios. GPT-4 ranked nephrology only above sleep medicine. While nephrology scored higher than hospice and palliative medicine, it fell short in key criteria such as work-life balance, patient relationships, and career demand. When examining the percentage of filled positions in the 2024 appointment year match, nephrology's filled rate was 66%, only higher than the 45% (155/348) filled rate of geriatric medicine. Nephrology's score decreased by 4%-14% in 5 criteria including intellectual challenge and complexity, procedural involvement, career opportunity and demand, research and academic opportunities, and financial compensation. ChatGPT does not favor nephrology over most internal medicine specialties, highlighting its diminishing appeal as a career choice. This trend raises significant concerns, especially considering the overall physician shortage, and prompts a reevaluation of factors affecting specialty choice among medical residents.

Determinants of brain drain among physicians in Turkey: Findings from a national exploratory study.

The shortage of physicians in Turkey is a highly critical emergency. In fact, physicians' migration to developing or high-income countries, defined as brain drain, threatens the sustainability of the national healthcare system. This study explored the driving factors associated with Turkish Physicians' brain drain, including high-economic inflation, social-politics, poor-living, equity, violence, and the desire to practice medical activity abroad. A cross-sectional survey of 1,861 Turkish physicians aged 25 to 65 years old was conducted employing the Brain Drain questionnaire, the Depression Anxiety Stress Scale (DASS-21), the Patient Health Questionnaire 9 (PHQ-9), and the Fatigue Assessment Scale (FAS). Significant differences were observed among physicians staying in Turkey versus considering migration to Western countries, regarding their age, gender, marital status, educational level, occupational status, work years, hospital night shifts, income, and cigarette/nargileh smoking habits (all p ⩽ .018). The main reasons for brain drain included transport problems, harassment, low salary, malpractice, bad environment, job insecurity, workload, burnout, treating difficult patients, inadequate postgraduate systems, peer-pressure, health safety concerns, and favoritism in the workplace, as well as stress and depression caused by work overload. In fact, depression, anxiety, stress, fatigue, and burnout varied significantly among the different groups of physicians (all p ⩽ .013). Additionally, key predictors of brain drain were better job opportunities, poor hospital management (in Turkey), job-related stress, dealing with difficult patients, research deficiencies, workload, burnout, transportation issues, short consultation time, low salary, and fatigue. Among the general factors contributing to the brain drain in the Turkish Health System, we identified significant issues related to research deficiencies, compulsory working duties, poor quality of postgraduate, inadequate medical-schools, poor hospital management, and shortage of consultants. Physicians' migration is a major global public health concern, leading to substantial risks for healthcare services, especially in Turkey. Many physicians decide to migrate to work in Western countries.

8076 Advancing Career Development of Physician-Scientists Engaged in Diabetes Research: Insights into the National K12 DiabDocs Program

Abstract Disclosure: K.D. Dasani: None. F.K. Bishop: None. S.H. Golden: None. L.M. Laffel: None. R.G. Mirmira: None. A.K. Steck: None. S.M. Willi: None. D.M. Maahs: None. L.A. DiMeglio: None. Background: In July 2022 the NIH established a multi-center National K12 “Diabetes-Docs: Physician-Scientist Career Development Program” (DiabDocs) to support mentored research experiences and tailored career development training for cohorts of physician scientists focused on diabetes research. DiabDocs scholars are board-certified or board-eligible physicians with training in pediatric or adult endocrinology or in another area tied to diabetes research and care. The program addresses the shortage of physicians engaged in diabetes research and is open to scholars at any eligible institution in the United States. Methods: The DiabDocs program was implemented by two multi-center Program Directors (MPD), in collaboration with an Executive Leadership Committee (ELC) comprised of experienced basic science and clinical/translational physician-scientists. Additional faculty from 19 different institutions have engaged in advisory and reviewer roles. The program solicits Letters of Intent (LOIs) annually from interested candidates followed by invitations for full applications; a program retreat features educational workshops and diversity training; and a Study Section selects Scholars. Currently, the program is in its third recruitment cycle for additional scholars to start Summer 2024. Additional career development programming is available through a series of interactive webinars. The program also has a strong commitment to diversity, equity, and inclusion, including a “DiabDiversity” program to support in-person engagement in DiabDocs experiences by under-represented in medicine trainees. Results: After two successful recruitment cycles in 2022-2023 that reviewed 24 LOIs, 11 scholars were selected. The funded scholars (6 Adult and 5 Pediatric Endocrinologists) include 3 individuals self-identifying as underrepresented in medicine and 7 females. For the 2023 application cycle, 24 LOIs were received (11 from Adult and 9 from Pediatric Endocrinology, 2 in combined Pediatric/Adult Endocrinology, and 2 from other specialties). Conclusions: The DiabDocs program aims to identify, recruit, and support outstanding early career physician scientists. The program provides a national network with resources for protected research time, career development programs, and national mentorship to develop cohorts of skilled professionals contributing to the advancement of diabetes research. Presentation: 6/2/2024