Dataset Information

Predicting In-State Workforce Retention After Graduate Medical Education Training.

ABSTRACT:

Background

There is a paucity of literature when it comes to identifying predictors of in-state retention of graduate medical education (GME) graduates, such as the demographic and educational characteristics of these physicians.

Objective

The purpose was to use demographic and educational predictors to identify graduates from a single Michigan GME sponsoring institution, who are also likely to practice medicine in Michigan post-GME training.

Methods

We included all residents and fellows who graduated between 2000 and 2014 from 1 of 18 GME programs at a Michigan-based sponsoring institution. Predictor variables identified by logistic regression with cross-validation were used to create a scoring tool to determine the likelihood of a GME graduate to practice medicine in the same state post-GME training.

Results

A 6-variable model, which included 714 observations, was identified. The predictor variables were birth state, program type (primary care versus non-primary care), undergraduate degree location, medical school location, state in which GME training was completed, and marital status. The positive likelihood ratio (+LR) for the scoring tool was 5.31, while the negative likelihood ratio (-LR) was 0.46, with an accuracy of 74%.

Conclusions

The +LR indicates that the scoring tool was useful in predicting whether graduates who trained in a Michigan-based GME sponsoring institution were likely to practice medicine in Michigan following training. Other institutions could use these techniques to identify key information that could help pinpoint matriculating residents/fellows likely to practice medicine within the state in which they completed their training.

SUBMITTER: Koehler TJ

PROVIDER: S-EPMC5319633 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Publications

Predicting In-State Workforce Retention After Graduate Medical Education Training.

Koehler Tracy J TJ Goodfellow Jaclyn J Davis Alan T AT Spybrook Jessaca J vanSchagen John E JE Schuh Lori L

Journal of graduate medical education 20170201 1

<h4>Background</h4>There is a paucity of literature when it comes to identifying predictors of in-state retention of graduate medical education (GME) graduates, such as the demographic and educational characteristics of these physicians.<h4>Objective</h4>The purpose was to use demographic and educational predictors to identify graduates from a single Michigan GME sponsoring institution, who are also likely to practice medicine in Michigan post-GME training.<h4>Methods</h4>We included all residen ...[more]

PMID: 28261398

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Project description:The United States has a well-trained, highly specialized physician workforce yet continues to have care gaps across the nation. Deficiencies in primary care and mental health specialties are most frequently cited, though critical shortages in multiple disciplines exist, particularly in rural areas. Sponsoring institutions of physician graduate medical education (GME) have created rural residency tracks with modest federal funding and minimal incentives, though efforts targeting shortages in these specialties and geographic locations have been limited. In response to access problems in the Veterans Health Administration, Department of Veterans Affairs (VA), the second largest federal funder of GME with the most expansive clinical education platform, Congress passed the Veterans Access, Choice, and Accountability Act of 2014. This act directed the VA and provided funding to establish 1,500 new positions, a 15% expansion of VA-funded positions at the time. Priority for position selection was given to primary care, mental health, and any other specialties the secretary of VA determined appropriate. Importantly, priority was also given to VA facilities with documented physician shortages, those that did not have GME training programs, those in communities with high concentrations of veterans, and those in health profession shortage areas. Many rural facilities match this profile and were targeted for this initiative. At the conclusion of fiscal year 2021, 1,490 positions had been authorized, and 21 of the 22 VA medical centers previously without GME activity had added residents or were planning to soon. Of the authorized positions, 42% are in primary care, 24% in mental health, and 34% in critically needed additional specialties. Targeted GME expansion in the VA, the largest integrated health care system in the nation, has been successful in addressing physician GME training that aligns with physician shortages and may serve as a model to address national physician specialty and geographic workforce needs.

Project description:PurposeTo create medical school service regions and examine national in-region graduate retention patterns across the medical education continuum and into professional practice as one approach to advancing social accountability in medical education.MethodsMedical school service regions were created in Canada using publicly available data and mapped using Geographic Information System (GIS) software. Population size and density for each service region were calculated using census data. Retrospective data of medical graduates who completed their medical degrees between 2001-2015 (n = 19,971) were obtained from a centralized data repository and used to analyze in-region retention rates by medical specialty across the training continuum and five years into professional practice.ResultsSpatial inequities were observed across medical school service regions. Graduate retention patterns also varied across service region groups and medical specialties. Quebec (86.5%) and Ontario (80.4%) had above-average retention rates across the medical education continuum. Family medicine had the highest retention rates from undergraduate to postgraduate training (81.9%), while psychiatry had the highest retention rate across the training continuum and into professional practice (71.2%). The Alberta and British Columbia service region group demonstrated high retention rates across the training continuum and into professional practice and medical specialties, except for retention from undergraduate to postgraduate medical education.ConclusionThis study highlights the importance of considering both medical specialty and practice location of graduates when planning and retaining the physician workforce. The observed retention patterns among graduates are a critical aspect of addressing societal needs and represent an intermediate step towards achieving health equity. Furthermore, graduate retention patterns serve as an outcome measure for schools to demonstrate their commitment to social accountability. Tracking and monitoring graduate outcomes may lead schools to actively collaborate with government agencies responsible for healthcare policy, which may ultimately improve physician workforce planning and promote more equitable healthcare access.

Dataset Information

Predicting In-State Workforce Retention After Graduate Medical Education Training.

Background

Objective

Methods

Results

Conclusions

Publications

Predicting In-State Workforce Retention After Graduate Medical Education Training.

Similar Datasets

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