Is this any way to solve the perceived primary care shortage?
A new survey shows that primary care professors’ compensation is 43% lower than their specialty care professor counterparts in the academic field.

Primary care professors reported a median compensation of $203,777, compared with $291,101 for specialty professors, according to a survey from the Medical Group Management Association (MGMA).

For department chairpersons, the compensation gap is even more stark. Specialty department chairpersons’ median compensation ($510,542) is a whopping 71% higher than their primary care peers ($299,500), according to the survey.

Nonetheless, the specialist versus primary care pay disparity in academic settings isn’t exactly shocking. That’s because that same disparity is seen in private practice.
For example, median compensation for internists stood at $216,000 in 2011, compared with $487,000 for radiologists and $424,000 for anesthesiologists, according to the MGMA’s most recent physician compensation report.
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According to the ACP, many residents in primary care track programs are no longer entering primary care. Many graduating residents are specializing.

Most internal medicine residents, even those in primary care residencies, don’t plan to practice general internal medicine, a recent survey found.

U.S. internal medicine residents were surveyed about their career plans while taking the Internal Medicine In-Training Examination (IM-ITE). Data were gathered from more than 57,000 residents who responded to the survey in 2009-2011. About a third of the responses came from third-year residents. Results were published in the Dec. 5 Journal of the American Medical Association.
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Medfools is actively reading and reviewing Personal Statements for the 2013 NRMP Residency Match! Our usual turnaround time is about 24-72 hours. Be sure to read thru a few example essays for inspiration (but don’t copy!) then get cracking! It is never too late to get to work on your essay. For those interested in our editing services, please visit http://medfools.com/askthefool.php

Good luck everyone!

According to the ACP: Increases in medical school enrollment are likely to almost meet the 30% target set by the Association of American Medical Colleges (AAMC) in 2006, according to new projections.

According to a survey conducted by the AAMC’s Center for Workforce Studies, first-year medical school enrollment is projected to reach 21,376 in the school year 2016-2017, a 29.6% increase over enrollment in 2002-2003, just short of the 30% increase by 2015 that the AAMC had called for.

Most of that growth (58%) will occur in the 125 schools that were already accredited in 2002. Schools that have been accredited since then will provide 25% of the increase, and the remainder (17%) will come from schools that are currently in applicant or candidate status with the Liaison Committee on Medical Education. More than half (56%) of the enrollment growth has already occurred, with 2,850 of the 4,888 slots available by 2011. Read the full story

The number of U.S. medical student seniors at medical schools choosing internal medicine residencies leveled off in 2012 after two years of significant increases, according to results from the 2012 Match Day.

The 2012 National Resident Matching Program (NRMP) report, released on March 16, showed that 2,941 U.S. medical school seniors matched internal medicine, nearly unchanged from the 2,940 who matched in the field in 2011.

“After seeing increases in 2010 and 2011 for the internal medicine residency match for U.S. medical students, we are disappointed that there was not a bigger increase this year,” said Virginia L. Hood, MBBS, MPH, FACP, ACP’s president. “We remain concerned about the need to significantly increase the nation’s internal medicine and primary care physician workforce to meet the needs of an aging population requiring care for chronic and complex illnesses.”
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Success on the Wards 250 Rules for Clerkship Success by Samir Desai and Rajani Katta, builds upon their successful library of medical student books with this terrific follow up. The purpose of the book is to guide 3rd year medical students thru life on the wards, with particular interest in getting things done right.

The book goes thru lists of “Rules” of what to do and what not to do. Some are general guidelines, and others are true things that you definitely should not do. The intro is very useful, summarizing what it means to be on a clinical clerkship and to be able to take care of patients. The chapter does a good job recapping why clerkships are important and what the various core clerkships are, and why they are important. When reading forward, you will find that some of the key points in the first few chapters are already mentioned in the intro, but we found the actual evidence and references made by the book particularly interesting. They cite residency directors and programs and reveal what programs find most important on various clerkships. There are also references to studies on what makes students successful on the wards, and what may reveal future problems as junior residents.

After the intro, we get right into the various clerkships from internal medicine, surgery, pediatrics, psychiatry, OBGyn, and Family Medicine. If you read these straight thru, you may find some things rather repetitive, such as recommendations to always be on time to rounds, and meetings. The overall information is very helpful, so it may be best to read each of these chapters are you are preparing to start the actual clerkship. There is great info on the nuances in how each specialty likes their progress notes, case presentations, and what to carry in your coat. In addition there are keys for success including how and who to ask to write letters of recommendation and some basic things to look for if applying to that specialty for residency. From an organizational perspective we would have put these chapters at the end of the book.

Probably one of the most overlooked parts of clerkships is really a few reminders on how to treat patients. There is a section on medical errors which even seasoned attendings should review, including things like preventing nosocomial infections and medication errors. There are also some real pearls on helping students introduce themselves to patients properly, how to convey confidence without being overbearing, and how to instill trust in your patients. This section has great information on conducting an effective patient interview, including things like asking open ended questions and not interrupting patients. Some of this may go un-noticed by your residents on the rotation, but will get noticed by patients and will help all students in the future as physicians. This key section of the book reminds students on respecting patients, clear communication, and staying professional.
The book moves on from there to go over how to prep and behave on new rotations, including what to wear, how to get things done, and how to stay focused. Clerkship keys including on-call where much of your time will be spent with the team (and therefore more eyes on the student) are discussed in detail, as well as how to review charts and write admitting orders. From there is a section on lab test interpretation as well as a few keys on abnormal labs. We found it a bit odd that it went into rather extensive detail on hyponatremia (a good review), but not other lab tests. This seemed a bit out of place from an editorial perspective.

Attending rounds, and the importance of observing bedside teaching is discussed, as well as ways to get residents or attendings to show you things that you may never learn again, like interpreting JVD or murmurs. In addition, the chapter gives nice tips on how to survive being pimped on the wards. The book goes on to talk about case presentations, write ups, outpatient clinics, evaluations, exams, rotations, attendings, teamwork, and everyone’s hated clerkship experience: giving talks to your team.

Success on the Wards 250 Rules for Clerkship Success is an excellent reference for any 3rd year medical student and some is probably great reading for advanced students and even residents and interns. The book would also be a terrific reference for international students or beginning interns to learn the US clerkship system. The book is well written and an easy read. The numerous literature supported references gives the book some real relevance and makes the evidence believable, instead of being heavily opinionated and only a few of one or two people. Given the heavy importance of being successful on the wards as a student for future residency, it’s really easy to recommend this book. Outside of 2 tiny quirks mentioned above on Hyponatremia and a preference to put a few chapters later in the book, really there are no real negatives at all!