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Community college pathways: improving the U.S. physician workforce pipeline.

ABSTRACT: To examine the association between participation in a community college (CC) pathway, medical school admission, and intentions to practice in underserved communities or work with minority populations.The authors performed cross-sectional analyses of the 2012 Association of American Medical Colleges matriculant and applicant files and the Matriculating Student Questionnaire to assess associations between student characteristics and participation in a CC pathway. They used logistic regression to estimate the association among CC pathway and acceptance to medical school, intention to practice in underserved areas, or intention to work with minority populations.There were 40,491 applicants and 17,518 matriculants to U.S. MD-granting schools; about one-third used a CC. A higher proportion of underrepresented minority (URM) matriculants used CC pathways compared with whites. Applicants who attended a CC after high school and before a four-year university (First-CC) had lower odds of acceptance into medical school (adjusted odds ratio [AOR] = 0.68; 95% CI 0.61-0.75; P < .05). Compared with medical students who never attended a CC, First-CC matriculants were more likely to have parents without a college education (304/895 [34%] versus 1,683/12,598 [13%], P < .001) and higher odds of intentions to practice in underserved communities (AOR = 1.26; 95% CI 1.04-1.53; P < .05), after adjusting for covariates.There is both high representation of URM students and higher prevalence of intention to work with underserved communities among CC pathway participants. These findings may be of interest to those seeking to enhance diversity in the physician workforce.

SUBMITTER: Talamantes E

PROVIDER: S-EPMC4245373 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Community college pathways: improving the U.S. physician workforce pipeline.

Talamantes Efrain E Mangione Carol M CM Gonzalez Karla K Jimenez Alejandro A Gonzalez Fabio F Moreno Gerardo G

Academic medicine : journal of the Association of American Medical Colleges 20141201 12

<h4>Purpose</h4>To examine the association between participation in a community college (CC) pathway, medical school admission, and intentions to practice in underserved communities or work with minority populations.<h4>Method</h4>The authors performed cross-sectional analyses of the 2012 Association of American Medical Colleges matriculant and applicant files and the Matriculating Student Questionnaire to assess associations between student characteristics and participation in a CC pathway. The ...[more]

PMID: 25076199

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Project description:ImportanceGiven the mortality disparities among children and adolescents in rural vs urban areas, the unique health care needs of pediatric patients, and the annual emergency department volume for this patient population, understanding the availability of pediatric emergency physicians (EPs) is important. Information regarding the available pediatric EP workforce is limited, however.ObjectiveTo describe the demographic characteristics, training, board certification, and geographic distribution of the 2020 clinically active pediatric EP workforce in the US.Design, setting, and participantsThis national cross-sectional study of the 2020 pediatric EP workforce used the American Medical Association Physician Masterfile database, which was linked to American Board of Medical Specialties board certification information. Self-reported training data in the database were analyzed to identify clinically active physicians who self-reported pediatric emergency medicine (EM) as their primary or secondary specialty. The Physician Masterfile data were obtained on March 11, 2020.Main outcomes and measuresThe Physician Masterfile was used to identify all clinically active pediatric EPs in the US. The definition of EM training was completion of an EM program (inclusive of both an EM residency and/or a pediatric EM fellowship) or a combined EM program (internal medicine and EM, family medicine and EM, or pediatrics and EM). Physician location was linked and classified by county-level Urban Influence Codes. Pediatric EP density was calculated and mapped using US Census Bureau population estimates.ResultsA total of 2403 clinically active pediatric EPs were working in 2020 (5% of all clinically active emergency physicians), of whom 1357 were women (56%) and the median (interquartile range) age was 46 (40-55) years. The overall pediatric EP population included 1718 physicians (71%) with EM training and 641 (27%) with pediatric training. Overall, 1639 (68%) were board certified in pediatric EM, of whom 1219 (74%) reported EM training and 400 (24%) reported pediatrics training. Nearly all pediatric EPs worked in urban areas (2369 of 2402 [99%]), and pediatric EPs in urban compared with rural areas were younger (median [interquartile range] age, 46 [40-55] years vs 59 [48-65] years). Pediatric EPs who completed their training 20 years ago or more compared with those who completed training more recently were less likely to work in urban settings (633 [97%] vs 0-4 years: 440 [99%], 5-9 years: 547 [99%], or 10-19 years: 723 [99%]; P = .006). Three states had 0 pediatric EPs (Montana, South Dakota, and Wyoming), and 3 states had pediatric EPs in only 1 county (Alaska, New Mexico, and North Dakota). Less than 1% of counties had 4 or more pediatric EPs per 100 000 population.Conclusions and relevanceThis study found that almost all pediatric EPs worked in urban areas, leaving rural areas of the US with limited availability of pediatric emergency care. This finding may have profound implications for children and adolescents needing emergency care.

Dataset Information

Community college pathways: improving the U.S. physician workforce pipeline.

Publications

Community college pathways: improving the U.S. physician workforce pipeline.

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