It's Academic

September 2014 

Clinical Training Sites Getting Harder to Find

Concerns over adequate numbers of clerkship or clinical training sites are widespread among medical schools as well as educational programs for advanced practice nurses and physician assistants, as reported in a joint study released by the Association of American Medical Colleges (AAMC). “Recruiting and Maintaining U.S. Clinical Training Sites: Joint Report of the 2013 Multi-Discipline Clerkship/Clinical Training Site Survey,” conducted by AAMC, the American Association of Colleges of Nursing, the American Association of Colleges of Osteopathic Medicine, and the Physician Assistant Education Association, assesses perceptions and experiences in securing clinical training sites for the three disciplines. 

More than 70 percent of respondents indicated it was more difficult in 2013 than in the previous two years to develop new clinical training sites. Respondents cited security and legal requirements and the need to provide training and orientation for preceptors as reasons. 

The three professions experienced the greatest difficulties in securing training sites for pediatrics and obstetrics-gynecology. Osteopathic medical schools were far more likely to pay for clinical training sites (71 percent) compared with only 15 percent of allopathic medical schools, 20 percent of physician assistant programs, and 4 percent of advanced practice nursing programs. But a majority of respondents indicated they felt pressured to pay for sites, particularly for new sites. Many programs offer nonmonetary incentives, such as faculty positions, professional development opportunities, library access, and public recognition to compete for sites. 

The Texas Higher Education Coordinating Board (THECB) conducted a 2012 survey of Texas medical schools on required clerkship availability, selective and elective rotations, and existing clinical education site capacity. “Undergraduate Medical Education: A Survey of Texas Medical Schools Clinical Clerkships and Rotations” reported five Texas medical schools were paying for clinical training sites. The remaining four schools did not pay. The report recommends developing graduate medical education positions in the state to better accommodate growing residency training needs. It also noted these sites could be used as clerkship sites for medical students.  

During the 2013 Texas legislative session, TMA and Texas medical schools successfully worked to pass legislation that prohibits THECB from awarding certificates of authority for courses leading to a medical degree to for-profit medical schools chartered in foreign countries. The American University of the Caribbean School of Medicine in St. Maarten had submitted an application for this authority to send students to Texas for their core clinical clerkships. 

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After Allowing for Inflation, Resident Compensation Unchanged in 40 Years

When adjusting for inflation, resident physician compensation has not increased in 40 years, according to Medscape’s Residents Salary & Debt Report 2014, which surveyed 1,279 U.S. residents in 25 specialty programs. In fact, factoring in housing costs and education-related debt as well as inflation, resident stipends are slightly less than 40 years ago. 

The report provides results of an online survey conducted in June that looked at what residents earn, their medical school debt during residency, and their satisfaction with their compensation and workplace relationships. Medscape reports the average national resident salary is $55,300, regional discrepancies are large, and gender salary disparity is relatively low. 

Residents in critical care specialties earned the highest salary of $65,000 with family medicine residents earning the lowest annual salary of $52,000. The survey revealed a 4-percent disparity for salaries between male and female residents; despite this, the results showed higher satisfaction with compensation among female residents (57 percent) compared with their male counterparts (48 percent). 

While the results didn't give a national debt average, they did look at how much debt residents carried at specific intervals after completing medical school. Thirty-six percent of those surveyed still owed more than $200,000 after five years in residency. The report notes that residents in the South Central region of the United States, which includes Texas, have some of the lowest debts, as well as some of the lowest resident salaries. The report speculated the lower debt in this region may be due to the fact that several Texas medical schools have some of the lowest tuition rates. Further, Texas has a high proportion of public medical schools in comparison with other regions of the country. 

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Committee to Focus on Health Care Workforce Shortages

Texas House Speaker Joe Straus created the Select Committee on Health Care Education and Training, which will focus on preparing more Texans for careers in the state’s growing health sector. Committee members will assess the demand for health professionals across the state. They also will examine ways to better align public schools, as well as colleges and universities, with the needs of health care employers. 

“The strength of our health care workforce directly impacts the quality of care that Texans receive,” said Speaker Straus (R-San Antonio). “It also matters a great deal to our economy. Too many health jobs are unfilled, while too many Texans are not prepared to succeed in the workforce. The work of this committee will help more Texans prepare for successful careers in a very important field.” 

Rep. Susan King (R-Abilene), a TMA Alliance member, will chair the committee. “As a nurse and a former school board member, Representative King understands the needs of our schools and our health care providers,” Speaker Straus said. “I am confident that she and all of the members of this committee will provide valuable leadership as we address this issue in the next legislative session.” 

Rodney B. Young, MD, chair of TMA’s Council on Medical Education, provided written comments for the select committee’s first meeting on Aug. 28.  

Dr. Young emphasized the continuing shortage of physicians in the state, both in terms of total numbers and the uneven distribution of physicians by practice specialty and geographic location. He cited two innovative programs developed by Texas medical schools that aim to produce physicians in the specialties most needed in the state in a shorter period of time. The Family Medicine Accelerated Track (F-MAT) at Texas Tech University Health Sciences Center in Lubbock and The University of Texas System’s Transformation in Medical Education (TIME) initiative are unique Texas programs that reduce physician education and training by at least one year. 

Dr. Young also drew attention to the need for state support for expanding graduate medical education programs to give the growing number of Texas medical school graduates a fair chance to pursue residency training in the state. TMA will continue to monitor the select committee’s work in the coming months for further reporting in It’s Academic

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Academic Physicians: TMA Believes Your Commitment and Leadership Deserve Recognition

TMA is eager to recognize Texas physician leaders who have simultaneously dedicated their lives to the care of their patients and to the preparation of the physician workforce of tomorrow. The TMA Award for Excellence in Academic Medicine recognizes teaching physicians who have a record of TMA leadership and serve as a role model in scholarly activity, mentoring, professional development, advocacy, or community service. If this sounds like you, TMA encourages you to apply for this award created for doctors like you.

“TMA wants to recognize our physician members who are exceptional teachers, mentors, and medical professionals,” said Rodney B. Young, MD, chair of the TMA Council on Medical Education. “Their contributions directly align with TMA’s vision to improve the health of all Texans, and this award program underscores their value in preparing the future physician workforce to be leaders within TMA and their communities.”

The program has four recognition levels: Bronze, Silver, Gold, and Platinum. Eligibility criteria increase with each level. Bronze, Silver, and Gold levels are self-nominating, and all who meet the criteria will receive recognition. A selection committee of TMA member physicians chooses the sole Platinum-level award winner each year from among Gold-level recipients. Gold recipients remain eligible for the annual Platinum award for three years, with no need to reapply during that period.

New this year is the opportunity to nominate a physician for recognition at one of the three levels. You can find information on the nomination process here

All recipients receive a printed certificate and recognition by the TMA Council on Medical Education and Subcommittee for Academic Physicians at the next TexMed, the TMA House of Delegates’ annual meeting. The Platinum Award winner also receives a $5,000 cash award and trophy, generously provided through a grant from the Texas Medical Association Foundation. In addition, all recipients receive recognition in TMA’s award-winning newsmagazine, Texas Medicine; It’s Academic; and the Handbook for Delegates at TexMed.

Physicians may download applications now through Dec. 8. Deadline for submission to TMA is Dec. 8, 2014, at 5 pm (CT). Apply today, and get the credit you’re due

If you have questions, contact Jennifer McHaney at TMA at (800) 880-1300, ext. 1451, or (512) 370-1451, or

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Baylor College of Medicine Appoints Dr. Brandt as Interim Senior Associate Dean for Medical Education

Baylor College of Medicine appointed Mary L. Brandt, MD, interim senior associate dean for medical education. Prior to this appointment, she served as associate dean of student affairs. She is continuing in her role as a professor of surgery, pediatrics, and ethics and is a practicing pediatric surgeon at Texas Children’s Hospital in Houston. 

Dr. Brandt completed medical school and general surgery residency training at Baylor College of Medicine. She is board certified by the American Board of Surgery in general surgery, pediatric surgery, and surgical critical care, completing her fellowship training in pediatric surgery at St. Justine Hospital of the University of Montreal. Dr. Brandt is an established clinical researcher who has published in numerous peer-reviewed journals on topics related to pediatric surgery and medical education.

Dr. Brandt’s primary research interest is designing prospective clinical trials in pediatric surgery to improve the outcomes for all children requiring surgery. She is director of the William J. Pokorny Fellowship and mentors residents and students in the design and implementation of pediatric surgical clinical studies. Dr. Brandt is the principal investigator for a National Institutes of Health study designed to research the outcome of bariatric surgery in adolescents and directs the Anorectal Malformation Clinic and Adolescent Bariatric Surgery program at Texas Children’s Hospital.

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Join Us for TEDMED Week Sept. 10-12 in Austin

TEDMED is where the world's most creative minds meet health care’s most innovative scientific concepts. And that’s why you need to be there. Speakers will cover ending the global physician shortage and revolutionizing medical education, among other topics. More

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We Could Use Your Help and Encourage Your Participation

TMA has been a longtime advocate for academic faculty and medical schools — monitoring legislation, determining the potential impact on patients, and lobbying for your interests.

TMA is extremely successful in Texas for one reason only. TMA speaks with one strong, firm, and consistent voice — the voice of its members. Only with grassroots support — only with your support — can we continue to be successful for you and your patients. 

Join or renew today, and see what a difference TMA membership can make. Within your department and/or academic institution, funds may be available to cover the cost of your membership. Please check with your department administrator or chair. 

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New-to-Texas Physicians Can Start Here

Are you a new Texas physician? Have you recruited a physician for your school from out of state?

TMA’s Welcome to Texas webpage can help new or returning Texans get their practices up and running. The page provides links doctors need to obtain a Texas license, plus contact information for relevant state and federal agencies and links to resources such as practice consulting for setups, health insurance plan contacts, and employee salary data.

TMA members can email the TMA Knowledge Center or call (800) 880-7955 for fast answers to questions about membership, TMA member benefits and services, practice management or legal information, and more.  

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This Month in Texas Medicine

The September issue of Texas Medicine features a cover story on the growing need for physician involvement in the Texas Medical Association Political Action Committee (TEXPAC) and the group’s mission to ensure medicine’s voice rings in the Texas Legislature and good health policy prevails. It also highlights Texas medical schools’ efforts to help students match, TMA’s latest scope-of-practice battles, the association’s role in recruiting physicians to care for veterans, and tropical disease emerging in Texas. Check out our digital edition.

Also, you can subscribe to RSS feeds for TMA Practice E-Tips, TMA news releases, Blogged Arteries, and Texas Medicine. More

It's Academic is for physicians in academic settings. For more information about TMA’s efforts on behalf of medical education and academic physicians, visit the TMA Council on Medical Education’s Subcommittee for Academic Physicians page on the TMA website.

Please share with your colleagues who are not TMA members and ask them to join.

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    The State legislature is unable to support the existing medical schools adequately. Another institution, no matter where it is located, would put more unnecessary strain on already stretched finances. Find the money to treat the ones you have better before straining draining resources.
    William E. Powell, M.D.

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