Sunday, March 10, 2013
In a healthy sign for the state’s future supply of primary care doctors, 69 percent of last year’s graduates of ECU’s Brody School of Medicine chose residencies in that field of medicine, according to a UNC Board of Governors annual report released early this year.
Sending 49 of the 73 members of its Class of 2012 into likely careers in primary care medicine satisfies a long-standing policy objective set for ECU’s medical school by the N.C. General Assembly. A 1993 state law addressing North Carolina’s chronic shortage of primary care doctors said Brody should aim for 60 percent of its graduates choosing residencies in that field. Primary care is defined as family practice, internal medicine, pediatrics and obstetrics-gynecology.
ECU did not achieve the 60 percent goal in the three previous years. However, it has exceeded the goal 13 times in the past 22 years, and achieved a high of 77 percent choosing primary care in 2005, according to data tracked by the Sheps Center for Health Services Research at UNC-Chapel Hill.
The law established the same 60 percent goal for the UNC-Chapel Hill School of Medicine. The report said 51 percent of UNC-Chapel Hill’s 165 graduates in 2012 chose a primary care residency. The state assigned 50 percent targets to the medical schools at Duke University and Wake Forest University, which are private schools. Duke saw 42 percent of its Class of 2012 choose primary care while 33 percent of Wake Forest’s 2012 graduates did.
While all four medical schools have initiatives encouraging students to aim for a career in primary care medicine, officials said cultural trends and a cap on Medicare reimbursements to hospitals for resident-training programs are making the job more difficult. Primary care doctors usually work longer hours and earn less than doctors who choose a specialty like radiology.
“Students are increasingly gravitating to specialties that allow them to control their hours and have less on-call nights and weekends,” the report said.
ECU’s continuing focus on the issue is lauded in the Board of Governors report, which concludes that, “With the exception of East Carolina University, the interest in primary care has declined among medical school graduates in the state.”
“The numbers for Brody in these reports usually look better than the other three medical schools, but this year stands out,” Dr. Tom Bacon, president of the N.C. Area Health Education Centers, said. Bacon also serves as executive associate dean of the UNC-Chapel Hill School of Medicine. “ECU started out with a commitment to train primary care doctors, and that continued commitment is still evident.”
“We don’t really deserve that praise,” BSOM Dean Paul Cunningham said. “That is what we’re supposed to do. That’s precisely the mission the school was created to serve.”
Cunningham credited BSOM’s new Family Medicine Center as a factor in the rebound in ECU’s numbers.
“Who could train in such a wonderful facility and not be attracted to primary care?” he asked.
Since 1980, 60 percent of graduates who completed a family medicine residency at Brody still are practicing medicine in North Carolina today.
Cunningham said that 98 of them, or 30 percent, are practicing medicine east of Raleigh.
The Board of Governors report specifically tracks where graduates of the state’s four medical schools are five years after graduation and the type of medicine they are practicing. Of the 67 BSOM graduates in 2006, 35 were practicing primary care medicine, either in North Carolina or another state, in 2011. ECU’s 52 percent primary care retention rate compares to 33 percent of UNC-CH’s 141 graduates in 2006.
Although it is the youngest and the smallest in enrollment of North Carolina’s four medical schools, Brody graduates now account for 26 percent of all doctors practicing in North Carolina who attended medical school in state, up from just 7 percent in 1990. UNC-trained doctors account for 42 percent of all physicians in the state who trained here; Wake Forest contributes 24 percent and Duke 8 percent.
The Board of Governors report also focuses on rural residents’ access to primary care medicine. Data indicate that of the 408 graduates of the state’s four medical schools in 2005, only 10 were practicing primary care medicine in a rural North Carolina county in 2011. Of those 10, four are Brody graduates, four are Carolina graduates and two are Wake Forest graduates, according to Sheps Center staff.
North Carolina’s rural residents have a slightly better chance of seeing a doctor than rural residents in other states. Here, there are 12 doctors per 10,000 rural residents, which compares to the national average of 11.4 doctors per 10,000 rural residents, according to AHEC data. Bacon cited that statistic as proof that North Carolina’s legislated interest in producing more primary care doctors is paying off.
Doctoral students earn internships
ECU’s doctoral program in health psychology announced on Feb. 27 that all eight of its doctoral candidates who applied for this year’s match process were selected for internships. The national selection process is highly competitive and is one of the final steps to becoming a professional psychologist.
The full-time, one-year internship is a requirement for earning the doctoral degree in clinical psychology or school psychology. Nationally, approximately 69 percent of candidates were matched through the internship service this year.
The health psychology program is housed in the Thomas Harriot College of Arts and Sciences’ Department of Psychology.
“The 100 percent placement of our students from East Carolina provides further evidence of the increasing national prominence of East Carolina in the field of health psychology,” Dr. Sam Sears, program director, said. “The top training sites in health psychology now recognize that students at East Carolina are engaged in state-of-the-art clinical practice and research.”
Clinical health psychology students selected for the internship — and their internship locations — are Katherine Buck, University of Colorado School of Medicine; Marissa Carraway, Cherokee Health Systems; Emily Dinatale, Medical College of Georgia & Charlie Norwood VAMC; Jessica Ford, Brown University Alpert Medical School; Jonathan Highsmith, Memphis VA Medical Center; Katie Lehockey, VA Western New York Healthcare System; and Amaris Tippey, University of Florida Health Science Center. Pediatric school psychology student Julie Harris, also selected for the match program, will conduct her internship at Illinois State University.
ECU’s heath psychology program began in 2007 and has three tracks: clinical health psychology, pediatric school psychology and occupational health psychology. This past year, the clinical health psychology program received a seven-year accreditation from the American Psychological Association. The pediatric school psychology program will seek similar accreditation in the upcoming year.
via The Daily Reflector.