By Jeffrey Susman, MD
The cost of medical school is increasing steadily. With students preferentially choosing specialty careers to quickly pay down their educational debt, there is a growing need for primary care physicians. The AAMC estimates that the United States will have a shortage of 46,000 primary care doctors by 2025. While African-Americans, Hispanics, and Native Americans represent 25 percent of the U.S. population, they constitute less than 6 percent of physicians. Clearly, we are failing to provide a culturally and economically diverse physician workforce.
Northeast Ohio Medical University (NEOMED), as a steward of regional health in Northeast Ohio, has faced this challenge by creating our Education for Service Initiative (EFS). The Education for Service Initiative will create a pipeline of students from economically, educationally, and culturally diverse backgrounds into the health professions. Our initiative is based on four components: pipeline, curriculum, community engagement, and scholarships.
Pipeline: From Middle School to Practice
Gaps in educational achievement begin very early, often within elementary education; therefore, we think of our pipeline as beginning in middle school. We work with local P-16 elementary education leaders, regional STEM initiatives (including a co-located STEM+M(edicine) School at the NEOMED campus in Rootstown), and existing pipeline programs to promote the health professions broadly.
We foster awareness of health careers; develop summer and year-round supplemental programs; and enhance connections between the medical school, local universities and community partners. We recognize the importance of enhancing opportunities for rural and urban underserved students. We believe this pipeline is strengthened by a longitudinal, coordinated, multi-stakeholder effort at multiple touchpoints during the middle- and high-school years. We are working with the Sullivan Alliance and colleagues at the state and regional level to assure we develop programs that build from existing strengths.
Together with our four collaborating universities—The University of Akron, Cleveland State University, Kent State University, and Youngstown State University—NEOMED is developing an Education for Service curriculum. Based on our efforts at the NEOMED academic campus at Cleveland State University, all students will complete an urban underserved concentration while participating in their bachelor’s or post-baccalaureate training. Coursework in population health, community medicine, and the social determinants of health will be required and reinforced with community projects. The curriculum will dovetail with a primary care track at NEOMED.
Community Engagement and Service Learning
We believe it’s important for students to work actively in neighborhoods and garner support, mentorship, and role modeling. Their community involvement will begin in early pre-professional experiences, continue in college, and extend through medical school. By focusing on a defined population, we will meld the strong personalized aspects of patient-centered care with the deeper understanding of the social determinants of health and community responsive service.
A clear barrier to a health professional career and primary care practice is affordability. By making scholarships available at both the college and medical school level, we will help students attain the dream of higher education and choose careers based on aptitude and proclivity, not on resolving substantial debt.