Recently, I was in a meeting organized by the American Academy of Family Physicians in an effort to understand the lack of student interest in family medicine as well as to encourage brainstorming among those of us charged with facilitating interest on ideas that might work and be transportable.
I was with Bill Coleman from Alabama (among others) and was pleased to discover that we were ahead of the region. We have mostly tried what has been shown to work (pipeline programs, selective admission, educational activities in medical schools among other things) and thanks to Bill have a budding Student AAFP chapter that is attracting attention.
What I found most impressive was the collection of students that the Academy had assembled. These 8 or so students were committed, enthusiastic, and engaged. They are the evangelists for family medicine for tomorrow. When asked how to improve interest, they did not offer Twitter or Facebook as the answer. They offered three concrete barriers that we will have to overcome if we want to increase the number of highly qualified applicants into our family medicine:
- Students want assurances that their income will be sufficient to cover the cost of their student loans. At current rates, they are scheduled to pay $36,000 annually for 10 years to retire an average debt. More and more, students going into primary care are able to obtain debt retirement through service commitments but we as educators need to do a better job of communicating the financial implications of a career in primary care and how to leverage desire into less debt.
- Students want mentors. Smart people who can enter any field they want select fields based on advice from mentors and peers. When their peers are all saying “take the money” they need strong mentors to reassure them that it is good to do the right thing for the right reason. Unfortunately, those of us teaching students often do not realize the impact of our verbalized frustrations. To quote from a previous generation, “Loose lips sink ships” and make anesthesiologists.
- Students need for us to sell family medicine to the public. They are committed to what they believe is a great specialty. When they brag to their family, they know they won’t hear excitement about impending brain surgery. They do expect to hear pride or at least acknowledgement that a family doctor is a bona fide specialist, and not someone at risk of being replaced by another professional without an MD. We need to do a better job of selling the specialty both in the social media and more importantly in the mass media.
In short, I think the future of the specialty is in good hands. It is our stewardship that makes me worry.
Allen Perkins is Professor and Chair, Department of Family Medicine, University of South Alabama. He blogs at Training Family Doctors.
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