Cost of Incremental Expansion of an Existing Family Medicine Residency Program.

BACKGROUND AND OBJECTIVES: Expanding residency training programs to address shortages in the primary care workforce is challenged by the present graduate medical education (GME) environment. The Medicare funding cap on new GME positions and reductions in the Health Resources and Services Administration (HRSA) Teaching Health Center (THC) GME program require innovative solutions to support primary care residency expansion. Sparse literature exists to assist in predicting the actual cost of incremental expansion of a family medicine residency program without federal or state GME support. METHODS: In 2011 a collaboration to develop a community health center (CHC) academic medical partnership (CHAMP), was formed and created a THC as a training site for expansion of an existing family medicine residency program. The cost of expansion was a critical factor as no Federal GME funding or HRSA THC GME program support was available. Initial start-up costs were supported by a federal grant and local foundations. Careful financial analysis of the expansion has provided actual costs per resident of the incremental expansion of the residencyRESULTS: The CHAMP created a new THC and expanded the residency from eight to ten residents per year. The cost of expansion was approximately $72,000 per resident per year. CONCLUSIONS: The cost of incremental expansion of our residency program in the CHAMP model was more than 50% less than that of the recently reported cost of training in the HRSA THC GME program.

Rising levels of New Zealand medical student debt.

AIM: There is little recent data on the debt levels accrued by New Zealand medical graduates. We aimed to quantify the level of student loan debt accrued by medical graduates upon completion of their medical degree, and to investigate the association of New Zealand Government Student Loan (GSL) debt with gender and age. METHODS: At graduation each year from 2006-2015, students from one New Zealand medical programme were invited to complete a career intention survey that included information on levels of GSL debt and the number of income sources used. RESULTS: The overall response rate was 83.8%. On average, 92% of domestic students reported having some student loan debt, with 28% a debt of $90,000 or more. The proportion of students reporting a student loan debt of $90,000 or more increased over the period of the study (P<0.0001). While older students were more likely to have a larger student loan debt than younger students, there was no difference in debt levels by gender. Students with larger student loans were more likely to rely on a larger number of financial sources to fund their studies. CONCLUSIONS: New Zealand medical students are carrying higher levels of student loan debt year on year. The effect of this on the future medical workforce is not certain; however, this could be negative if graduates choose to enter careers that are more highly paid over areas of high need. The full impact of large loans on individuals and the health system will take years to determine.

Helping Trainees Develop Scholarship in Academic Medicine From Community Service.

Introduction: Service in the community and academic medicine are often seen by trainees as unrelated. This may be one reason for the lack of faculty diversity and the declining interest in academic medicine among new trainees. Methods: We developed an educational workshop through the application of the Kern model to help medical students and residents understand the relationship between community service work and scholarship as it pertains to a career in academic medicine. Specifically, the workshop helped trainees (1) understand the terms service and scholarship, (2) understand the benefits of achieving community service scholarship, and (3) identify steps to achieve community service scholarship through mock cases and personal stories. Results: The workshop was implemented at five conferences with a total of 139 trainees. Results of a paired-samples t test of learners' responses pre- and postworkshop showed statistically significant growth in their confidence to publish service-related work, as well as more positive agreement with the notion that community service work aligns with an academic medicine career. Discussion: This effective module can help trainees understand how community service and academic medicine are aligned, and raise their confidence in building a foundation for an academic medicine career through conducting community service scholarship.

'I had to use food banks as I have had literally no money'.

Millions of pounds have been paid to debt-ridden nursing students to prevent them from dropping out of university courses. Data exclusively obtained by Nursing Standard shows £5.2 million in discretionary funding has been handed out since 2013.

[Tools for junior scientists support from medical societies: survey amongst members organized in the Association of the Scientific Medical Societies (AWMF)]. / Förderung des wissenschaftlichen Nachwuchses durch medizinische Fachgesellschaften - Umfrage unter den Mitgliedsgesellschaften der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V. (AWMF).

INTRODUCTION: A decreasing number of young physicians go for an academic career. The most frequently cited reasons are deficient structures and a lack of perspectives. The German Research Foundation warned against supply gaps in the medical sciences and in 2010 published recommendations for the improvement of professional development at all levels of medical education. A systematic survey of existing support tools and their dissemination among the medical societies has not yet been conducted. METHOD: Network members of the AWMF were contacted by e-mail and asked to answer 59 questions regarding the support of junior scientists in their respective societies. RESULTS: 28 out of 147 societies replied to the questionnaire. Most of the societies offer at least one of the following tools (multiple responses; selective topics): award for oral presentations (n=27), free attendance at conferences (n=15), financial research funding (n=19), assessment of any funding application (n=10), mentoring (n=6), support of students working on their doctoral thesis (n=26), support of studies abroad (n=16), training course on statistics/ laboratory methods (n=17), support with clinical studies (n=22). DISCUSSION: Here, we present our survey findings on established support tools for junior scientists for the first time. Apart from the medical schools, several medical-scientific societies have also started to provide tools of support for their junior scientists. However, to ensure that long-term perspectives and attractive conditions are provided in the field of medical science for junior scientists, broader support and interdisciplinary exchange of established tools are needed.