Will Today's Medical Students Have Enough Training for Your Practice?

With the current physician shortage expected to grow over the next decade, many practices will soon be heavily recruiting current medical students and recent graduates. However, before they do so, they should gain a better understanding of the education that today's students are receiving and fill any gaps to ensure the success of their new hires.

New Challenges on the Horizon

In 2013, the Council on Graduate Medical Education (COGME) published its 21st report in which it identified a number of challenges - both current and upcoming - in graduate medical education in the U.S. In addition to known problems such as underserved locations and an aging population, COGME also warned that many teaching hospitals fail to sufficiently emphasize primary-care training and crucial skills such as team-based practice and care coordination. And accreditation bodies, according to COGME, have been slow to adjust their curriculums. The report also noted that the healthcare delivery system is changing more rapidly than medical education is, as resources such as EHRs, mobile medical apps, and patient portals are implemented in greater numbers.

Are American Postgraduate Programs Equipped to Handle These Challenges?

A study appearing in a 2013 issue of JAMA Internal Medicine compared the 2003 restrictions on duty hours for medical trainees (every fourth night overnight call with 30-hour duty limits) with those established in 2011 (every fifth night overnight call or a night float schedule, both with 16-hour duty limits). It found that the change in duty hour restrictions led to deteriorations in educational opportunities, continuity of patient care, and perceived quality of care among residents and nurses. The researchers recommended the exploration of new models of training, which might include online learning platforms and mobile technology such as tablets.

What Can We Learn from Residency-Equivalent Programs Overseas?

In an editorial posted on KevinMD.com on Sept. 1, 2013, Justin List, an internal medicine physician, compared his residency experiences to international residency-equivalent programs. List wondered if shorter work hours and a longer training period would have a positive effect on evidence-based education and patient outcomes, but he lamented that little research has been completed regarding how American residents stack up when compared with residency equivalents internationally. Comparing students from each program could provide valuable insights into where we need to improve our postgraduate medical education here in the U.S..

How to Identify Talent

No formal rankings of residency programs exist. So the best way to identify the top U.S. programs is by speaking with other doctors. Physicians in large organizations typically work with other doctors from a wide range of backgrounds and therefore should be able to recommend programs that turn out quality doctors based on their colleagues' performance and experiences. If you're unable to reach out to physicians locally or through the professional organizations with which you're affiliated, then a recent report by U.S. News & World Report might be a good place to start. Their large-scale survey of 3,410 physicians identified Massachusetts General Hospital (Boston), Johns Hopkins University (Baltimore), and Brigham and Women's Hospital (Boston) as three of the top internal medicine residency programs. (Each received at least 600 nominations from those surveyed.)

Set Them Up for Success

When hiring physicians who've recently completed postgraduate training, you can help ease the transition by providing administrative support and mentoring. Be prepared to bring them up to speed by using informative literature and training sessions on alternative healthcare delivery systems within your practice. Establish a point of contact in the office, such as your practice manager or an administrative assistant - someone whom the new hire can feel free to turn to with any administrative questions or scheduling concerns. Additionally, match the new hire with a physician mentor. Providing this type of one-on-one support in the beginning will help new physicians overcome any disparities between what they learned during postgraduate training and what they need to know in order to succeed in your practice.