Kozakowski Stanley M, Travis Alexandra, Marcinek Julie P, Bentley Ashley, Fetter Gerald T
Medical Education Division, American Academy of Family Physicians.
Fam Med. 2017 Oct;49(9):686-692.
This annual report is an expansion on previous reports in this series that provides further evidence that the current medical school system is failing, collectively, to produce the primary care workforce that is needed to achieve optimal health in the United States. Inclusion of data on the performance of DO-granting and international medical schools, creates a more complete and complex picture of the contribution of all medical school types to the primary care workforce that should allow stakeholders to set goals, identify institutions with models from which to learn, and develop strategies for continuous improvement. US MD graduates made up 49% of the entering first-year class of family medicine residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME), a percentage that is not statistically changed from the 11-year average of 46%. Over the same time, the percentage of DO graduates in the entering class has been increasing at an annual rate of 1%, while the percentage of international graduates has been decreasing in a reciprocal manner. Production of family medicine graduates has varied widely between and within medical school types. The number of graduates entering family medicine programs accredited by the ACGME underrepresents the overall family medicine output by US medical schools since up to a third of DO graduates have historically entered residencies accredited only by the American Osteopathic Association. While marked differences between public and private continue among US MD-granting medical schools, the percentages are nearly equal between public and private for DO-granting medical schools, with a slightly higher percentage for private schools.
本年度报告是该系列以往报告的扩展,提供了进一步证据,表明当前的医学院系统总体上未能培养出美国实现最佳健康所需的基层医疗劳动力。纳入关于授予博士学位的医学院和国际医学院表现的数据,能更全面、复杂地展现各类医学院对基层医疗劳动力的贡献,这应有助于利益相关者设定目标、识别可借鉴模式的院校,并制定持续改进策略。美国医学博士毕业生占经研究生医学教育认证委员会(ACGME)认证的家庭医学住院医师项目一年级入学新生的49%,这一比例与11年平均水平46%相比无统计学变化。同一时期,入学班级中博士毕业生的比例以每年1%的速度增长,而国际毕业生的比例则以相反的方式下降。不同医学院类型之间以及同一类型内部,家庭医学毕业生的产出差异很大。经ACGME认证进入家庭医学项目的毕业生数量未能充分代表美国医学院的整体家庭医学产出,因为历史上高达三分之一的博士毕业生进入了仅由美国骨科协会认证的住院医师项目。虽然美国授予医学博士学位的医学院中公立和私立之间仍存在显著差异,但授予博士学位的医学院中公立和私立的比例几乎相等,私立学校的比例略高。