Supporting Medical Student Interest in Family Medicine

By Julie Phillips, MD, MPH, Assistant Dean for Student Career & Professional Development, Associate Professor, Sparrow-MSU Family Medicine Residency, Michigan State University College of Human Medicine

The American Academy of Family Physicians and the seven other national Family Medicine organizations have announced an important new goal for the discipline of Family Medicine: that 25% of graduates of U.S. medical schools will choose the specialty by 2030. In order to have a well-functioning healthcare system, most experts say that about half of the physician workforce should be in primary care. However, right now, only about 12% of U.S. allopathic and osteopathic students enter Family Medicine residency programs. Family Medicine is the only medical specialty in which the vast majority of graduates eventually practice primary care medicine.
 
Achieving ambitious goals, like this one, requires all of our efforts, regardless of practice setting. Medical student specialty choice is a complicated issue, and most students are influenced by many people in their path toward Family Medicine careers. It is worthwhile for each of us to reflect on how we can influence students. What follows are some of my own observations and reflections on what an individual Family Physician can do to encourage the future
Family Medicine workforce.
 

Plant Seeds Early

Most of us care for children in our practices and interact often with some who are gifted. Many of these children come from disadvantaged backgrounds.
Promoting economic diversity in the physician workforce is important, because medical students from low-income families are more likely to choose careers in Family Medicine. Medical students from rural backgrounds and racial and ethnic minority students also enter Family Medicine at a higher rate. Studies have demonstrated that children’s career aspirations are shaped in significant ways, even during the elementary school years, by the expectations of role models and mentors.
 
If you see a gifted child in your practice, talk with the child and his/her parents about college. If you care for high school and college students, look for that “spark” of a future Family Physician and talk with that student about a career in Family Medicine. Even small moments of mentorship and encouragement can make an important difference to that student.
 
Many physicians also seek opportunities to talk with students in public schools, at community organizations, or at local colleges about careers in Family Medicine.
 

Connect with Your Local Family Medicine Interest Group

Many students begin medical school with an interest in primary care, but the culture of medical education often discourages them. Research shows that it is incredibly important for medical students to have mentors who demonstrate that careers in Family Medicine are feasible and rewarding. All Michigan medical schools have Family Medicine Interest Groups (FMIGs) or student chapters of American College of Osteopathic Family Physicians. Student leaders of these groups would be delighted to have a physician from the community speak with them about their career path. If public speaking isn’t for you, ask whether you can participate in another way. If the group needs a faculty advisor, volunteer. To connect with an FMIG in Michigan, contact the medical school Student Affairs office, MAFP at 517.347.0098, or Michigan’s regional (Region 3) FMIG coordinator.
 

Precept Medical Students in Your Practice

The national shortage of Family Physicians extends into academic medicine: there are not enough physician teachers of Family Medicine. Medical schools are constantly seeking community physicians who will work with medical students for rotations, some for four or eight weeks at a time, and some spread out over several months. During this time, a student will learn from you by seeing patients with you, and learn from your team by helping in other areas of your practice. Most schools also welcome preceptors who see patients in different contexts, such as hospitals, long-term care facilities, or urgent care centers.
 
This opportunity is a great way to get to know a student as an individual. Patients usually welcome the opportunity to teach when the student’s role is explained. Although physicians often worry that they will not be able to teach while seeing patients, medical students can be incorporated into most offices’ work flow seamlessly. Students can also help you with important tasks, like patient education and history-taking, with appropriate guidance. Medical
students are generally enthusiastic, bright, eager to learn, and flexible; whatever your practice style, they will adapt to it. If you are new to precepting, the medical school should offer resources to help you in developing your skills while optimizing efficiency. You are also likely to receive a faculty appointment.
 

Host a Student for a Summer Opportunity

If you do not have a medical school campus nearby, consider welcoming a medical student into your practice for a summer. MAFP has a Medical Student Externship program, funded jointly by Family Medicine Foundation of Michigan and AAFP Foundation, which allows a student to spend a month or more with a mentoring Family Physician or Family Medicine researcher. The deadline to apply for the 2019 externship is April 1. 
 

Contribute to Family Medicine Education

Students who choose Family Medicine typically have a strong identity with the specialty. This identity can be built through Family Medicine scholarships, attendance at state or national conferences, or opportunities to pursue summer research or shadowing experiences. These unique opportunities are made possible through financial support. As you consider your personal giving, ask your medical school’s Family Medicine department if they have funds that directly support medical students. Family Medicine Foundation of Michigan provides support for medical student programs across the state.
 
The AAFP Foundation also supports students through the Family Medicine Leads signature program, funding FMIGs, student scholarships to the AAFP National Conference of Family Medicine Residents and Medical Students, a student leadership program called the Emerging Leaders Institute, and
many state summer externship programs.
 

Be an Advocate

Medical schools vary widely in the proportion of their graduates who become Family Physicians. Information about medical school performance is published annually in Family Medicine, which is publicly available. If your local medical school or alma matter is not serving your community by encouraging students to choose Family Medicine, challenge their leadership to do better. Family Medicine curricula, support for Family Medicine faculty and departments, and vocal support for Family Medicine from institutional leaders can make a big difference.
 

Keep in Touch

I have often thought that we give too little attention to the end of the third year and the beginning of the fourth year of medical school. Students can have great FMIG experiences and wonderful Family Medicine clerkships, but if they do not continue to develop their identify as future Family Physicians, other specialties can attract their interest. If you mentor students along their educational path, keep in touch. Offer to take them out for coffee. Ask them how their
specialty decision is coming along. Offer to write a letter of recommendation. Most of all, let them know that you care about them and see their future potential.
 
Family Doctors are essential for community health. The future of the health of our nation depends on Family Medicine achieving the 25x2030 goal. Achieving 25x2030 in Michigan will require all our efforts at many levels. Regardless of your role or practice setting, consider ways that you can be a mentor and teacher who helps build a strong workforce for our future.