Archives

  • www.xinsurance.com
Advertisement
The Newspaper for the Future of Miami
Connect with us:
  • Facebook
  • Twitter
  • Instagram
  • Linkedin
Front Page » Top Stories » Primary Care residencies rise, but still too low

Primary Care residencies rise, but still too low

Written by on September 6, 2022
  • www.miamitodayepaper.com
Advertisement
Primary Care residencies rise, but still too low

There is a slight increase in the number of physician residents going to primary care, but the number still low compared to the national demand as more medical graduates are choosing emergency medicine and surgical subspecialities, according to officials from Miami’s medical schools.

The Herbert Wertheim College of Medicine from Florida International University, founded in 2006, is still a relatively small medical school, but Robert Levine, M.D., associate dean of graduate medical education, said post-medical students are choosing more surgical subspecialities and emergency medicine. “We’ve had emergency medicine in our school go from almost invisible to almost 10% of the class. That’s a big hit.”

Of the surgical subspecialities, more Herbert Wertheim students are going into otolaryngology, plastic surgery, thoracic and vascular surgery, radiology and orthopedics, he said. Psychiatry has been ranking high too, he added, as well as obstetrics and gynecology. “We got about another 10% [of classes annually] going into Ob-Gyn.”

Over the last couple of years, there has been a small increase in the number of medical students interested in doing residencies in emergency medicine. “Part of that is because of the tremendous increase in the number of programs,” he said.

According to ResidentSwap.org, which lists vacant residency spots, there are 20 emergency medicine programs in Florida where post-graduates do five-year residences. Some of those programs include HCA Healthcare’s East Florida Division GME and USF Morsani College of Medicine GME, Florida Atlantic University Charles E. Schmidt College of Medicine Program, University of Central Florida, University of Florida, University of Miami at Jackson Health System Program, Mount Sinai Medical Center of Florida, Florida State University College of Medicine Program, and University of South Florida Morsani Program.

“Last year we saw a bit of a drop-off in interest,” said Dr. Levine. “This year has rebounded. We’ve had about 13 students, 10% of the class, interested in matching into Emergency Medicine.”

The pandemic moved the entire nation toward telemedicine, he added. “It is now part of graduate training, especially in primary care specialties. We just started our own course for medical students, based in Baptist [Health System hospitals], so they can rotate through and learn the basics of how to take care of people through telehealth.”

As many physician training institutions began expanding and all-together implementing telemedicine, the Accreditation Council for Graduate Medical School says it believes that it will become more integrated into practice in a substantial way, especially for primary care specialties, such as family medicine and pediatrics. In addition, tele-consultative medicine, said Dr. Levine, will become a huge change in how specialists communicate among themselves for patient care, and it will be better implemented in medical training.

Each subspecialty in medicine, he added, gets about 1% or 2% of the class each year. Some medical specialties are shared between internal medicine and family medicine, such as sports medicine and emergency medicine, which may have subspecialities, like critical care fellowships.

A study led by Dr. Mark Deutchman from the University of Colorado School of Medicine, published in 2020, showed that although about almost half of medical graduates undergo internal medicine residencies, about 22% of them stay as internists or go into primary care.

“But now you have specialties like emergency medicine, which didn’t exist 40 years ago,” coming out of internal medicine programs, said Dr. Levine. “There’s definitely still a need for more primary care physicians, like internal medicine, family medicine, and pediatrics. So, there is no problem getting jobs in those fields.”

According to the National Residency Matching Program, in 1952 there were about 6,000 medical graduates nationwide with 10,400 spots available for interns. In 1973, there were 10,000 graduates with about 19,000 spots available for interns. And in 2022, there were 36,277 positions for 47,675 people that had registered in the Match.

Of those 47,675 graduates, 9,902 were US medical school M.D. seniors, 7,303 were US doctor of osteopathic medicine seniors, about 5,000 were US students from offshore schools or international medical schools, and almost 8,000 were non-US international medical students.

In this year’s Main Residency Match, a total of 36,277 post-graduate students matched into American programs, a 93.9% success rate, according to the American Medical Association. There were 1,433 fewer international medical graduates, according to the matching program.

About 34% of FIU medical students did a Florida residency, about 20% did a residency in South Florida, and about 50% did a residency in primary care, said Dr. Levine. “Of the students I counsel, probably about 80% of them have family in Miami-Dade or Broward counties and would love to come back and practice in our area.”

Latha Chandran, M.D., M.P.H., executive dean of the University of Miami Miller School of Medicine and founding chair of the Department of Medical Education, said a third of the university’s medical students go into a primary care specialty, “because it’s the most common specialty, but more than half of them will subspecialize.” For pediatric medicine, about 71% of graduates will go into specialties, she said.

According to the Association of American Medical Colleges’ 2021 Report on Residents, where graduates do their residency most of the time is where they will end up working. “That’s why we are very interested when our students stay at Jackson [Health System] to do the training, because then we know a good number of them will stay there.”

She said 35% of Miller School graduates end up staying in Florida. In general, 60% of doctors who are women tend to stay in the state where they do their residencies, compared to 57% of male doctors, according to the report.

Dr. Chandran said she sees a slight increase in graduates choosing primary care specialties, “something of a 10%, but nothing too substantive, both in internal medicine and family medicine.” Salaries for subspecialties, such as vascular surgery and interventional radiology, which are substantially higher than family medicine and primary care, are factors that contribute to resident physicians’ decisions, she said.

“[At UM] we attract a lot of students from minority communities,” she said. “Students coming from minority communities tend to work in primary care and tend to work with underserved populations because they connect with them. So, by training those students we are definitely contributing to the healthcare of hundreds of communities without a doubt.”

  • www.miamitodayepaper.com
Advertisement