Future Docs

The nation spends billions of dollars every year training future doctors. But health care experts worry we’re still not training enough doctors to prevent a serious shortage.

Next in our Future Docs series, we explore the problem and some possible solutions.

Brian Drolet is a fourth year plastic surgery resident at Rhode Island Hospital. He’s originally from New Hampshire, and went to medical school at Vanderbilt University. He says he’s drawn to plastic surgery because of the variety of cases.

Interesting story from the American Medical Association’s news wire today about the growing number of medical students who are opting to pursue careers in family medicine. Students matched with family medicine residencies are up 14%this year from 2008, the writer reports (based on information from the national residency matching program).

Researchers writing in Academic Medicine, the journal of the Association of American Medical Colleges, think so. Or rather, after crunching the numbers – medical school debt load to potential income and expenses – they think medical students who decide to go into primary care as a specialty will be able to pay off their school debt on a primary care doctor’s salary.

But…

We’re checking in on our Future Docs Sarah and Peter, whom we’re following all year to learn more about becoming a doctor in today’s changing health care landscape. They’re half way through their second year of medical school now, and they’re already grappling with career decisions and the realities of a hospital’s sickest patients.

By KRISTIN GOURLAY

Sarah Rapoport is a second year student at Brown University's medical school. She's 24, a New Yorker, and already an accomplished scientist. When we last checked in with her, she was waiting for her cardiology exam results and had just started doing shifts in an emergency department. She did great. Now, she's thinking about her future.

"It's constantly a conversation in the back of my head," she says.

Medical residents still work loooong hours, longer than most of us will ever work in a single week at a paying job: 80+ hours. But that’s down from much longer work-weeks, a mandate from the Accreditation Council on Graduate Medical Education (ACGME) after complaints that long hours were contributing to woozy residents, too sleepy to make the best decisions for their patients.

After medical school, most doctors go through a kind of on-the-job training called residency. Residency programs have been around for a while, but some recent changes in those programs are impacting not only how residents practice but how patients receive care. So in the next Future Docs story, we take a look at residency from two angles. First, we meet third year general surgery resident Anne Kuritzky, who takes us on morning rounds on the surgical intensive care unit. Then, I join our Morning Edition host Elisabeth Harrison in the studio to talk about the showdown ahead on Capitol Hill over residency program funding and the changing needs driving residency specialization.

Coming up next in Future Docs, meet third-year surgical resident Anne Kuritzky. This Thursday on Morning Edition on Rhode Island Public Radio, join Anne on her morning surgical rounds, and then join me right after for a brief discussion about what’s changing for residency programs and how that affects patients and doctors.

Ed Wing, Dean of Medicine and Biology at The Warren Alpert Medical School of Brown University, will be stepping down at the end of this academic year. He’ll return to Brown after a sabbatical to continue teaching, researching, and writing. Meanwhile, the university will launch a national search for his replacement.

A new study in the journal Academic Medicine provides one of the first looks at a program created by the Affordable Care Act in 2010 to train more primary care doctors. It’s a pretty different model than the traditional one, where the government, through Medicare, makes payments to teaching hospitals to help fund graduate medical education (like a residency program for doctors-in-training).