Porfeli Erik J, Nakae Sunny, Amiri Leila, Harrison Leila E, Ross Will
Department of Human Sciences, The Ohio State University, Columbus, Ohio, USA.
California University of Science and Medicine, Colton, California, USA.
Health Equity. 2025 Aug 25;9(1):405-411. doi: 10.1177/24731242251371526. eCollection 2025.
The U.S. medical education system attracts and trains the next generation of physicians to advance the health care needs of a growing and increasingly diverse nation. This system can be credited for supplying a physician workforce achieving remarkable growth and innovation, yielding one of the world's most technologically advanced health care systems on the planet. This system, unfortunately, also contributes to educational, workforce, and health disparities.
The successes and challenges of the medical education and health care system align with broader economic, health, and educational patterns in the United States. An ecological model can be employed to unite a network of partners spanning four developmental stages to support a greater diversity of students for and from underrepresented communities to enter the physician workforce, enjoy the rewards granted by a career in medicine, and enact needed changes to eliminate health, economic, and educational disparities.
Comprehensive and ecologically attuned pathways to the physician workforce could be especially beneficial to states and communities suffering from the looming high school enrollment cliff, outflows of residents to other states, challenges in recruiting and retaining physicians, and significant educational and health disparities. The ecosystem model spurs significant changes in how we think about the developmental pathways to the physician workforce and how we may mobilize resources to promote progress and ease transitions, especially for underrepresented students who face many fewer opportunities and many more challenges along their journey.
美国医学教育系统吸引并培养下一代医生,以满足这个不断发展且日益多样化的国家的医疗保健需求。该系统因培养出一支实现了显著增长与创新的医生队伍而备受赞誉,造就了全球技术最先进的医疗保健系统之一。然而,不幸的是,这个系统也导致了教育、劳动力和健康方面的差距。
医学教育和医疗保健系统的成功与挑战与美国更广泛的经济、健康和教育模式相契合。可以采用一种生态模型,将跨越四个发展阶段的合作伙伴网络联合起来,以支持来自代表性不足社区的更多样化学生进入医生队伍,享受医学职业带来的回报,并进行必要的变革以消除健康、经济和教育方面的差距。
全面且符合生态规律的进入医生队伍的途径,可能对那些面临高中入学率即将断崖式下降、居民外流到其他州、招聘和留住医生方面的挑战以及严重的教育和健康差距的州和社区特别有益。生态系统模型促使我们在思考进入医生队伍的发展途径以及如何调动资源以促进进步和缓解过渡方面发生重大转变,尤其是对于那些在其求学过程中面临更少机会和更多挑战的代表性不足学生而言。