C.L. Coe is assistant professor of family medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0003-3851-0295 .
H.M. Baker is program manager, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
Acad Med. 2021 Oct 1;96(10):1436-1440. doi: 10.1097/ACM.0000000000003946.
The U.S. primary care workforce remains inadequate to meet the health needs of the U.S. population. Effective programs are needed to provide workforce development for rural and other underserved areas.
At the University of North Carolina (UNC) School of Medicine (SOM), between November 2014 and July 2015, the authors developed and implemented the Fully Integrated Readiness for Service Training (FIRST) Program, an accelerated curriculum focused on rural and underserved care that links 3 years of medical school with a conditional acceptance into UNC's 3-year family medicine residency, followed by 3 years of practice support post-graduation. Students are recruited to the FIRST Program during the fall of their first year of medical school. The FIRST Program promotes close faculty mentorship and familiarity with the health care system, includes a longitudinal quality improvement project with an assigned patient panel, includes early integration into the clinic, and fosters a close cohort of fellow students.
As of March 2020, the FIRST Program had successfully recruited 5 classes of medical students, and 3 of those classes had matched into residency. In total, as of March 2020, 18 students had participated in the FIRST Program.
The FIRST Program will be expanded to additional clinical sites across North Carolina and to specialties beyond family medicine, including pediatrics, general surgery, and psychiatry.
美国的初级保健劳动力仍然不足以满足美国人口的健康需求。需要有效的计划为农村和其他服务不足地区提供劳动力发展。
在北卡罗来纳大学(UNC)医学院(SOM),作者于 2014 年 11 月至 2015 年 7 月期间开发并实施了完全综合服务培训(FIRST)计划,这是一个侧重于农村和服务不足的护理的加速课程,将 3 年的医学院与 UNC 为期 3 年的家庭医学住院医师实习期联系起来,之后是 3 年的毕业后实践支持。学生在医学院第一年的秋季被招募到 FIRST 计划中。FIRST 计划促进了密切的教师指导和对医疗保健系统的熟悉,包括一个与指定患者小组相关的纵向质量改进项目,包括早期融入诊所,并培养了一个紧密的同学群体。
截至 2020 年 3 月,FIRST 计划已成功招募了 5 个医学专业的学生,其中 3 个班级已匹配到住院医师实习。截至 2020 年 3 月,共有 18 名学生参加了 FIRST 计划。
FIRST 计划将扩展到北卡罗来纳州的其他临床站点以及家庭医学以外的专业,包括儿科、普通外科和精神病学。