Sarah A. Shaffer, DO, MME

Sarah A. Shaffer, DO, MME. University of Iowa Hospitals and Clinics. Clinical Associate Professor of Obstetrics and Gynecology-General Obstetrics and Gynecology Department of Obstetrics and Gynecology Clerkship Director - Obstetrics & Gynecology. University of Iowa Carver College of Medicine, Iowa City, Iowa

Primary Care Tracks in Medical Schools

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine. Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors. Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care. Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

Palliative Care Education in the Family Medicine Clerkship:

Introduction: Inadequate training of medical students in palliative care has been identified as a barrier to its universal provision. Family medicine physicians frequently provide these services, yet the extent of palliative care training in the family medicine clerkship has been unknown. This study describes the status of palliative care training in the family medicine clerkship, as well as clerkship director perceptions of this training. Methods: Data were attained through a cross-sectional survey of 141 US and Canadian family medicine clerkship directors administered in fall 2016. Survey items included clerkship director perceived value, interest, and background in palliative care education; presence of educational objectives; hours of training provided; and perceived barriers to palliative care instruction. Results: Of the clerkship directors who responded (120/141, 81.5%), 31 (25.8%) reported providing no palliative care education and 75 (62.5%) reported palliative care competencies were not specifically assessed. Background in palliative care and explicit educational objectives were associated with more hours of training in palliative care. Clerkship director training in palliative care correlated with value of teaching it in the clerkship. Conclusion: Palliative care education in the family medicine clerkship is prevalent but a large portion of clerkships do not offer it, and the majority of clerkship directors do not evaluate this learning. Our study found a positive correlation between clerkship director training in palliative care and value placed on palliative training in the family medicine clerkship. Assessing this training in the family medicine clerkship and pursuing additional clerkship director training in the subject could improve the overall quality of education provided.