Stories from Texas Medicine, February 2016

Retaining Medical Graduates in Texas - 04/27/2018

Texas ranks 43rd in the country in ratio of physicians to patients. Recruiting and encouraging in-migration of physicians, although strengthened by the 2003 liability reforms and streamlining of the licensing process, remain inadequate in keeping up with the state's continuing population growth. Identifying effective mechanisms to retain the young men and women who graduate from medical school in Texas for their graduate medical education (GME) is an important goal. To meet its physician workforce needs, the state must provide adequate opportunities for college graduates to enter medical school, enough GME positions for any medical graduate who chooses to remain in the state for graduate training, and adequate numbers of fellowship programs.

Furthering Medical Education in Texas - 04/27/2018

Medical education in Texas is moving in the right direction. The Texas Medical Association has been a major partner in advancing medical education initiatives. This special symposium issue on medical education examines residency training costs, the Next Accreditation System, graduate medical education in rural Texas, Texas' physician workforce needs, the current state of education reform, and efforts to retain medical graduates in Texas.

The Family Medicine Accelerated Track at Texas Tech University Health Sciences Center - 05/25/2016

Meeting Texas' future health care needs will be challenging, including the goal for a physician workforce more balanced toward primary care. To help expand the primary care physician workforce, Texas Tech University Health Sciences Center (TTUHSC) School of Medicine developed the Family Medicine Accelerated Track (FMAT), a three-year curriculum that culminates in the MD degree and links medical students to family medicine residency programs at TTUHSC campuses in Lubbock, Amarillo, or the Permian Basin (Odessa and Midland). Twenty current family medicine residents are graduates of the FMAT program, and 30 medical students are enrolled in the program, which is charting a path for curricular innovation in medical education that will be increasingly competency-based.

The Revolution in Medical Education - 05/25/2016

Medical education has been gradually evolving for hundreds of years, but educators are now seeking to identify ways to prepare students for the future of health care delivery. Medical education reform today focuses on creating entirely new models and is moving away from the traditional, post-Flexnerian organization of the medical school curriculum. Content is now being integrated thematically and presented along interdisciplinary lines with an interdigitation of basic and clinical sciences across all four years. Current trends indicate education should contain elements that produce a physician who is able to improve the quality of health care by taking a humanistic approach to medicine, thinks critically, and participates effectively in multidisciplinary and team approaches to patient care. Ultimately, medical education innovation should recognize the development of a physician is a lifetime process and will approach the formation of physicians from a new paradigm to better serve the e...

The Next Accreditation System - 05/25/2016

The Accreditation Council for Graduate Medical Education has implemented a new accreditation system for graduate medical education in the United States. This system, called the Next Accreditation System, focuses on more continuous monitoring of the outcomes of residency training, and for high-quality programs, less on the detailed processes of that training. This allows programs to innovate to best meet the needs of their trainees and communities. This new system also reviews the clinical learning environment at each institution sponsoring graduate medical education, focusing on professionalism, trainee supervision, duty hour and fatigue management, care transitions, and integration of residents into patient safety and health care quality. This Next Accreditation System is too new to fully assess its outcomes in better preparing residents for medical practice. Assessments of its early implementation, however, suggest we can expect such outcomes in the near future.

Costs Associated With Residency Training - 05/25/2016

Texas needs more physicians to care for a rapidly growing population, and new physicians who complete medical training in Texas are likely to remain in the state to practice. The expansion of existing Texas medical schools, along with the development of new schools, has created a need for a corresponding increase in residency and fellowship (graduate medical education, or GME) positions in Texas, and the 2013 and 2015 legislative sessions have funded expanded GME support. While the Centers for Medicare & Medicaid Services pays for the majority of GME positions nationally, those numbers were capped in 1997. Growing populations, particularly in the southern states, have led many institutions — when funds are available — to increase GME positions "over the cap." Texas physicians need to be aware of costs associated with development of accredited GME positions, as well as other measures being taken to support the growth of the physician workforce in the state.

Experience-Based Lessons From Rural Texas Graduate Medical Education - 05/13/2016

The University of Texas Medical Branch in Galveston (UTMB) family medicine residency program established a rural training track (RTT) in Weimar, Texas, in 2000. The UTMB-RTT provided a training environment designed specifically to prepare family physicians for rural practice in Texas. From 2000 to 2015, 17 family medicine residents completed their training and graduated from the UTMB-RTT. Despite successes with graduate training, rural placement after program completion, and recruitment of underrepresented minorities, the UTMB-RTT closed in June 2015. This paper describes the strengths of and challenges experienced by the program, as well as lessons learned to inform future endeavors.