Primary care and the three year medical student

It’s well documented on this blog that the primary care shortage will only worsen once most of America has access to affordable health insurance.

As I wrote in a recent op-ed. not only will there a shortage of primary care physicians, but nurse practitioners and physician assistants won’t alleviate the problem either, mostly because they are also enticed by the lucrative allure of specialty practice.

Enter the three-year primary care physician.

Texas Tech University is experimenting with such a program. Apparently, the fourth year of medical school was deemed expendable:

… the program was designed out of the conviction that most of the fourth year of medical school was focused on electives in various medical specialties—programs that are important for those considering specialized residencies, but that may not be necessary for those committed to primary care. Texas Tech believes that, with a few adjustments, it can provide those who plan careers in family medicine with the necessary parts of the fourth year earlier—and free up the year.

It’s an interesting idea that I hadn’t thought of. I can see how medical students can be enticed by a year less of medical school. For some, that can both shave off $50,000 or more in medical school tuition and bring them a real-world physician salary earlier.

But that would also lock the student in a primary care track early on. The fourth year is where students taste the various medical specialties that ultimately influence their residency decisions.

Maybe that’s the point. Perhaps shielding them from the lifestyle advantages, not to mention the financial benefits and relative lack of bureaucratic hassles, of specialty practice is one way to convince more to choose primary care as a career.


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