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Rx for Research and Primary Care

Private research-intensive medical schools can do more to promote primary care careers

By JAKE MILLER
January 11, 2013

Despite increasing demand for primary care physicians, the percentage of new physicians pursuing primary care careers has declined over the past decade. U.S. medical students often reject primary care careers in favor of greater specialization.  A new study in the Journal of General Internal Medicine finds that graduates of private research-intensive medical schools are significantly less likely than their counterparts from public research-intensive medical schools to enter family medicine residencies or to practice as primary care physicians after completing their training.

“This study highlights the potential for medical schools to train more primary care physicians while maintaining a strong research program, as numerous public medical schools have done,” said senior author John Ayanian, professor of health care policy and medicine at HMS and a practicing primary care physician at Brigham and Women’s Hospital.  

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Phillip Choi and Shuai “Steve” Xu, medical students from the University of Pittsburgh School of Medicine and Harvard Medical School, respectively, along with senior author Ayanian analyzed research funding from the National Institutes of Health, residency data from the American Academy of Family Physicians, school characteristics from the Association of American Medical Colleges, and data on practicing physicians’ clinical fields from the American Medical Association Physician Masterfile.

They found that recent graduates of private research-intensive medical schools were significantly less likely to be practicing as primary care physicians (24 percent) than graduates of public research-intensive medical schools (36 percent) and those of less research-intensive private (33 percent) and public medical schools (36 percent).

“These results show that private research-intensive schools can do more to encourage their students to consider primary care careers,” Choi said.

In addition, graduates of private research-intensive medical schools were less likely to enter family medicine residencies (2 percent) than graduates of public research-intensive medical schools (6 percent).

“Private research-intensive medical schools attract many talented students.  If more of these students become primary care physicians, they can be innovative leaders in transforming clinical practice and educators of the next generation,” Xu said.

“We know that we are not producing enough primary care physicians, and this analysis suggests that private research-intensive medical schools can do more,” said Russell Phillips, HMS William Applebaum Professor of Medicine and director of the Harvard Medical School Center for Primary Care, who was not involved in the study. “Strong systems of primary care improve quality of care and reduce costs, and institutions such as Harvard have the capacity to train outstanding biomedical investigators and primary care physicians who will lead the needed transformation of our healthcare systems.”

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