1. The Student Interest Portfolio: Departments Share Successes And Collaborations University of Kansas School of Medicine Deb Clements, MD Scott Moser, MD Florida State University College of Medicine Curt Stine, MD Johns Hopkins School of Medicine Adam Dimitrov, MD AAFP Division of Medical Education Amy L. McGaha, MD Ashley DeVilbiss

2. Objectives Discuss efforts underway to support family medicine workforce and identify stakeholders in each of the 3 areas of focus. Review the evidence about factors influencing specialty choice of family medicine. Learn about current activities underway in the CARE model. Identify successful programming and interventions from schools with differing infrastructure and resources. Identify ways to engage students in advocacy efforts.

3. Sufficient FM Workforce Depends on: Sufficient Recruitment Appropriate Training Continued Retention

5. Multiple Complex Factors Admission Practices Medical School Mission Socioeconomic Status Personality Gender Age Marital Status Geographic Background Academic Background Career Intentions Values and Knowledge of Students Ethnicity Medical School Experiences Premedical Pipeline Lifestyle Debt Role Models & Mentors Legislative Mandates Income Dept Structure Educational Experience Preclinical Curriculum Required FM Clerkships Primary Care Tracks Faculty Competency Hidden Curriculum Type of Med School

6. Primary care tracks increase SI & choice FM clerkships longer, rural, >1 site Rural and lower SES medical students Highly competent FM preceptors and role models positively influence medical student interest Most medical students have some interest in primary care at admission, though that appears to be decreasing. Rural, older and lower income students are less likely to be admitted to allopathic medical schools Student encouragement by FPs is likely an important factor Lifestyle issues and debt may impact specialty choice Family physicians play key roles in the medical school curriculum but are generally perceived as “quiet” Attendance at the AAFP National Conference or other family medicine meetings with targeted student programming may increase interest Family physicians can influence individual students and medical school administration which can impact med school admissions Highly active FMIGs recruit and retain students

7. Evidence-Based Student Interest Portfolio of Activities Role Models Admissions/ Pipeline Communications Education ADVOCACY

8. Update from KU Med Scott Moser, MD –KU-Med Wichita Deb Clements, MD –KU Med Kansas City

9. Recruitment: Pre-admission Prematriculation: Doc for a Day: FMIG open house for high school students JayDoc Community Clinic: safety net clinic, includes premed students New: statewide primary care participation in high school programs Admissions: Committee participation Candidate interviewers: full time and volunteer faculty

10. Recruitment: Predoctoral Preclinical: PBL group leaders Preceptors for intro to clinical medicine Clinical: FM Clerkship goal: the best organized, most clinically relevant, most student-appreciated core clerkship Ditto for senior rural preceptorship Interesting/flexible senior electives JayDoc Community Clinic Extra-curricular: KAFP Foundation funding of FMIG NCFMRS scholarships

11. Recruitment: Curriculum Leadership: Associate Dean for Education Education Council Chair Phase II (Yr 3-4) Committee Chair Curriculum development: New: Distributive model

12. Training Preceptor workshops Academic detailing

13. Retention Affordable, high-quality CME Academic Detailing KAFP participation/communication

14. Florida State University College of Medicine Curtis C. Stine, M.D. January, 2009

15. Communications & Image Mission: “The Florida State University College of Medicine will educate and develop exemplary physicians who practice patient- centered health care, discover and advance knowledge and are responsive to community needs, especially through service to elder, rural, minority and underserved populations.” Organizational structure: Department of Family Medicine and Rural Health (DFMRH) is 1 of 5 departments Student organizations: Active FMIG External support: –Florida Legislature –FAFP and Community FP’s throughout FL

16. Admissions & Pipelines Admissions process: –Attempt to assess the applicant’s “mission fit.” –DFMRH Faculty on Admissions Committee: 5 FP faculty; 3 more DFMRH faculty; 2 geriatric/FP’s 4 community FP faculty; 1 FP resident Pipeline programs: –Pre-health professions advising office SSTRIDE program: middle school, HS and undergraduate MAPS –BRIDGE program: post-baccalaureate

17. Role Models & Mentors FM Faculty as: –Leaders: Dean, Sr. Assoc. Dean for Education, Assist. Dean of Student Affairs*, Chair of year 3 and 4 curriculum committee, Electives Coordinator all Family Physicians. Assoc. Dean for Faculty Development, Director of Informatics, Chair of Chair of year 1 and 2 committee have appointments in DRMRH Members of committees: Admissions (7), Curriculum (2), Student E and P (2) –Advisors (Academic and Professional): Individual students*, Learning Communities*, and Student organizations –Clinicians: All faculty see patients

18. Educational Elements Required courses: –Doctoring 1/Doctoring 2 (years 1 and 2) –Summer Clinical Practicum (between yrs. 1 and 2) –D3/Longitudinal Preceptorship (year 3) –Family Medicine Clerkship (year 3) –Advanced Family Medicine Clerkship (year 4) Electives: (year 4)

19. Educational Elements: Years 1 and 2 Required courses: –Doctoring 1/Doctoring 2 (years 1 and 2) FM faculty present in large group FM faculty facilitate small groups FM faculty teach clinical skills in Clinical Learning Center Community FPs as preceptors (> 70% if total) –Summer Clinical Practicum (between yrs. 1 and 2) Three week duration/community sites FM faculty as course director Community FPs as preceptors (46% of total)

20. Educational Elements: Years 3 and 4 Required courses: –D3/Longitudinal Preceptorship (year 3) One-half day weekly/Community sites FM faculty as course director Community FPs as preceptors (52% of total) –Family Medicine Clerkship (year 3) 6 weeks/Community sites Community FPs as clerkship directors at each regional campus Community FPs as clerkship faculty –Advanced Family Medicine Clerkship (year 4) 4 weeks/Residency sites or rural sites Residency faculty or community FPs as clerkship faculty Electives: (year 4)

21. Questions? Discussion? Ashley DeVilbiss –Student interest manager –(800)274-2237 ext 6722 –adevilbi@aafp.orgadevilbi@aafp.org Amy McGaha, MD –Assistant Director Medical Education –(800)274-2237 ext 6710 –amcgaha@aafp.orgamcgaha@aafp.org

22. The Johns Hopkins-Franklin Square Experience: The Value of Community-Based Residency Programs in the Mentoring of Orphan Schools Adam Dimitrov, M.D. Director of Undergraduate Clinical Education Franklin Square Hospital Department of Family Medicine Baltimore, MD

24. 20 minutes from Hopkins Not affiliated No faculty appt No family medicine department No required family medicine rotation Communication barriers due to being off-campus

28. Maryland Physician Workforce Study Co-sponsored by MHA and MedChi Presentation to The Maryland Governor’s Taskforce on Physician Workforce and Reimbursement ~ 2008

29. Total Clinical Physicians per 100,000 Residents by Region Compared to State and National Levels

32. Factors Negatively Impacting Recruitment in Maryland 3=High importance 2=Moderate importance 1=Low importance

33. Family Medicine. September 2008. Volume 40 Issue 8

36. Our rotation Off-campus site for required ambulatory medicine rotation (3 rd or 4 th year) Experience designed based on student’s interests and level of training Aim is to show student’s broad scope family medicine Students see patients with faculty and residents in the clinic Didactic teaching/case-based discussion/EBM focus Focus on note writing Specialty clinics (sports med, colpo, derm) with the Family Health Center residents

37. If you build it, will they come?

38. Using the Academy Support from the AAFP (Ashley and Amy) –Target schools Support from the MAFP Foundation Summer externship program

40. Feed the Orphans

41. Predoc Initiative