American Journal of Health Research

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Capacity for Development of Primary Care Residency Programs in Non-Teaching Hospitals in New York State (NYS)

Received: 03 December 2014    Accepted: 20 January 2015    Published: 30 January 2015
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Abstract

Purpose: The demand for physicians in the U.S., especially those practicing adult primary care, is accelerating and will inevitably require the expansion of residencies, despite current constraints on funding for graduate medical education (GME). A previous study showed little interest in or capacity for expansion of primary care residencies in current teaching hospitals in NYS. This study examines the interest in and capacity for establishing new programs among current non-teaching hospitals in that state. Design and Methods: Chief Executive Officers of eligible non-teaching hospitals in NYS were surveyed and asked if they had interest in establishing a residency program, what medical specialties they would choose assuming availability of additional funds, and what barriers there were to residency development. Results: Fourteen of 46 (30%) NYS sites completed the survey. All but one was interested in establishing residencies; 85 percent would establish new programs in Emergency Medicine; 76 percent in Family Medicine; and 54 percent in Internal Medicine and/or Primary Care Internal Medicine. Virtually all cited significant concerns related to funding, faculty supply, and need for medical school affiliations. Conclusions: A minimum of 28 percent of non-teaching hospitals in NYS have a significant interest in establishing a GME program. If implemented this could increase training in Family Medicine by 40 percent and Internal Medicine by 11 percent. However, there are formidable financial and structural barriers to doing so. Enhanced support programs that go beyond lifting of the current GME cap will be necessary to increase the training of primary care physicians.

DOI 10.11648/j.ajhr.20150301.13
Published in American Journal of Health Research (Volume 3, Issue 1, January 2015)
Page(s) 13-17
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Graduate Medical Education, Primary Health Care, Family Medicine, Medical Residency, Medical Workforce

References
[1] Dorsey ER, Nicholson S, Frist WH. Commentary: improving the supply and distribution of primary care physicians. Acad Med. 2011; 86(5): 541-43.
[2] Association of American Medical Colleges. Physician shortages to worsen without increases in residency training [Internet]. Washington D.C.: Association of American Medical Colleges; 2010 [cited 2014 August 12]. Available from: https://www.aamc.org/download/150612/data/md-shortage.pdf.)
[3] Edelman N, Romesier J. Financing of graduate medical education. In: Johns MM, Chair. Ensuring an effective physician workforce for America: recommendations for an accountable graduate medical education system. Atlanta: Josiah Macy Jr. Foundation; 2010 October. p. 149-68.
[4] Edelman NH, Goldsteen RL, Goldsteen K, Yagudayev S, Lima F, Chiu L. Institutions with accredited residencies in New York State with an interest in developing new residencies or expanding existing ones. Acad Med. 2013; 88(9): 1287-92.
[5] Health Forum. AHA Guide to the Health Care Field, 2009 Edition. 1st ed. Washington, D.C.: American Hospital Association; 2008. 1100 p.
[6] Garibaldi RA, Popkave C, Bylsma W. Career plans for trainees in internal medicine residency programs. Acad Med. 2005; 80: 507-12.
[7] Smart DR. Physician characteristics and distributions in the US, 2011 Edition. 1st ed. Chicago: American Medical Association Press; 2010. 500 p.
[8] Schuur JD, Venkatesh AK. The growing role of emergency departments in hospital admissions. N Engl J Med. 2012; 367: 391-93.
[9] Chen C, Petterson S, Phillips RL, Mullan F, Bazemore A, O'Donnell SD. Toward graduate medical education (GME) accountability: measuring the outcomes of GME institutions. Acad Med. September 2013; 88(9):1267-80.
[10] Riaz MP, Palermo T, Yen M, Edelman, N H. Potential Responses of Sponsoring Institutions to Reduction of Medicare Support for Graduate Medical Education [GME]. Acad Med. 2014; Forthcoming.
[11] Jolly P, Erickson C, Garrison G. US graduate medical education and physician specialty choice. Acad Med. 2013; 88(4): 468-74
[12] J.Eden, D. Berwick, G.W. Wilensky. Graduate medical education that meets the nation’s needs [Internet]. Washington, DC.: Institute of Medicine, Committee on the Governance and Financing of Graduate Medical Education; 2014 [cited 2014 November 16]. Available from: http://www.iom.edu/~/media/Files/Report%20Files/2014/GME/GME-RB.pdf
Author Information
  • Medical Student at Stony Brook University School of Medicine, and affiliate of, Department of Preventive Medicine and Program in Public Health, Stony Brook University, Stony Brook, New York.

  • Associate Professor of the Master of Public Health Program, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota

  • Professor and Founding Director, Master of Public Health Program, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota

  • Medical Student, Albany Medical College, Albany, New York, and affiliate of, Department of Preventive Medicine and Program in Public Health, Stony Brook University, Stony Brook, New York

  • Medical student, Ross University School of Medicine, Commonwealth of Dominica and affiliate of, Department of Preventive Medicine and Program in Public Health, Stony Brook University, Stony Brook, New York

  • Professor of Preventive Medicine and Internal Medicine and core member of the Program in Public Health, Stony Brook University, Stony Brook, New York

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  • APA Style

    Fabio V. Lima, Karen Goldsteen, Raymond L. Goldsteen, Laura Chiu, Shamuel Yagudayev, et al. (2015). Capacity for Development of Primary Care Residency Programs in Non-Teaching Hospitals in New York State (NYS). American Journal of Health Research, 3(1), 13-17. https://doi.org/10.11648/j.ajhr.20150301.13

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    ACS Style

    Fabio V. Lima; Karen Goldsteen; Raymond L. Goldsteen; Laura Chiu; Shamuel Yagudayev, et al. Capacity for Development of Primary Care Residency Programs in Non-Teaching Hospitals in New York State (NYS). Am. J. Health Res. 2015, 3(1), 13-17. doi: 10.11648/j.ajhr.20150301.13

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    AMA Style

    Fabio V. Lima, Karen Goldsteen, Raymond L. Goldsteen, Laura Chiu, Shamuel Yagudayev, et al. Capacity for Development of Primary Care Residency Programs in Non-Teaching Hospitals in New York State (NYS). Am J Health Res. 2015;3(1):13-17. doi: 10.11648/j.ajhr.20150301.13

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  • @article{10.11648/j.ajhr.20150301.13,
      author = {Fabio V. Lima and Karen Goldsteen and Raymond L. Goldsteen and Laura Chiu and Shamuel Yagudayev and Norman H. Edelman},
      title = {Capacity for Development of Primary Care Residency Programs in Non-Teaching Hospitals in New York State (NYS)},
      journal = {American Journal of Health Research},
      volume = {3},
      number = {1},
      pages = {13-17},
      doi = {10.11648/j.ajhr.20150301.13},
      url = {https://doi.org/10.11648/j.ajhr.20150301.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajhr.20150301.13},
      abstract = {Purpose: The demand for physicians in the U.S., especially those practicing adult primary care, is accelerating and will inevitably require the expansion of residencies, despite current constraints on funding for graduate medical education (GME). A previous study showed little interest in or capacity for expansion of primary care residencies in current teaching hospitals in NYS. This study examines the interest in and capacity for establishing new programs among current non-teaching hospitals in that state. Design and Methods: Chief Executive Officers of eligible non-teaching hospitals in NYS were surveyed and asked if they had interest in establishing a residency program, what medical specialties they would choose assuming availability of additional funds, and what barriers there were to residency development. Results: Fourteen of 46 (30%) NYS sites completed the survey. All but one was interested in establishing residencies; 85 percent would establish new programs in Emergency Medicine; 76 percent in Family Medicine; and 54 percent in Internal Medicine and/or Primary Care Internal Medicine. Virtually all cited significant concerns related to funding, faculty supply, and need for medical school affiliations. Conclusions: A minimum of 28 percent of non-teaching hospitals in NYS have a significant interest in establishing a GME program. If implemented this could increase training in Family Medicine by 40 percent and Internal Medicine by 11 percent. However, there are formidable financial and structural barriers to doing so. Enhanced support programs that go beyond lifting of the current GME cap will be necessary to increase the training of primary care physicians.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Capacity for Development of Primary Care Residency Programs in Non-Teaching Hospitals in New York State (NYS)
    AU  - Fabio V. Lima
    AU  - Karen Goldsteen
    AU  - Raymond L. Goldsteen
    AU  - Laura Chiu
    AU  - Shamuel Yagudayev
    AU  - Norman H. Edelman
    Y1  - 2015/01/30
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ajhr.20150301.13
    DO  - 10.11648/j.ajhr.20150301.13
    T2  - American Journal of Health Research
    JF  - American Journal of Health Research
    JO  - American Journal of Health Research
    SP  - 13
    EP  - 17
    PB  - Science Publishing Group
    SN  - 2330-8796
    UR  - https://doi.org/10.11648/j.ajhr.20150301.13
    AB  - Purpose: The demand for physicians in the U.S., especially those practicing adult primary care, is accelerating and will inevitably require the expansion of residencies, despite current constraints on funding for graduate medical education (GME). A previous study showed little interest in or capacity for expansion of primary care residencies in current teaching hospitals in NYS. This study examines the interest in and capacity for establishing new programs among current non-teaching hospitals in that state. Design and Methods: Chief Executive Officers of eligible non-teaching hospitals in NYS were surveyed and asked if they had interest in establishing a residency program, what medical specialties they would choose assuming availability of additional funds, and what barriers there were to residency development. Results: Fourteen of 46 (30%) NYS sites completed the survey. All but one was interested in establishing residencies; 85 percent would establish new programs in Emergency Medicine; 76 percent in Family Medicine; and 54 percent in Internal Medicine and/or Primary Care Internal Medicine. Virtually all cited significant concerns related to funding, faculty supply, and need for medical school affiliations. Conclusions: A minimum of 28 percent of non-teaching hospitals in NYS have a significant interest in establishing a GME program. If implemented this could increase training in Family Medicine by 40 percent and Internal Medicine by 11 percent. However, there are formidable financial and structural barriers to doing so. Enhanced support programs that go beyond lifting of the current GME cap will be necessary to increase the training of primary care physicians.
    VL  - 3
    IS  - 1
    ER  - 

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