1. STFM Annual Meeting New Orleans, LA August 30, 2011

2.  This session will address very pertinent issues including ◦ Why Family Medicine is the prestigious stuff: Becoming a leader and letting your light shine ◦ Residency: Managing the Match, options in choosing a residency, writing your personal statement, ◦ Funding: How to pay off Medical School-- Practice options that can help

3.  At the end of the session students should have ◦ Increased knowledge of the varied family medicine residency opportunities that fit the students interest (Women’s Health, Geriatric, Obstetrics, Sports Medicine) ◦ Increased knowledge of career opportunities in Family Medicine (Academic Medicine, Private Practice) ◦ Role Models in Family medicine and Mentors that they can contact to help them as they progress through the match ◦ Knowledge and resources to assist them in finding loan repayment resources.

4.  The Group on MMCH decided at the Vancouver meeting to have a special project at the New Orleans annual meeting  The program was to bring minority students to the meeting  Have a session to increase there knowledge of the discipline  We raised over 3000.00  Launched a campaign to find up to 20 local students  We have three  Not a failure but to me a success

5. Judy Washington MD Medical Director Women and Family Health

6.  Projections show that with declining medical student interest in Family Medicine there will be a workforce shortage ◦ the Association of American Medical Colleges estimates that there will be a shortage of approximately 45,000 PCPs by 2020  5400 Black /AA physicians  7200 Hispanic/Latino physicians  The Affordable Care Act authorizes funds to carry out the National Health Service Corps Scholarship and Loan Repayment Program ◦ The scholarship program covers tuition, fees, and costs for students enrolled in a medical degree program. [ ◦ After graduation, recipients of the scholarship are expected to work for up to four years as a primary care physician in an area of need. ◦ The Loan Repayment Program is available to to primary care physicians in exchange for two years of service in a community-based area of high need.  The ACA proposes to increase the number of primary care residency positions.

8.  Total Black applicants 297  Hispanic/Latino 204 Far Below thee number needed to fill the workforce gaps

9.  In 2010 AAMC data showed that of 79,070 total students enrolled in US Med Schools  5548 ( 7%) were African American or Black ( 12.3 % of US pop -2010)  17378 (22%) were Asian (4.8 % -pop)  654 (0.8%) were Native American( 0.9%)  6508 (8%) Hispanic /Latino (16 % US pop)  2058 ( 3%) were Mexican  1646 (2%) were Puerto Rican  47,525 (60%) were Caucasian (72.6%) https://www.aamc.org/download/147312/data/table29 -gradsraceeth0210_test2-web.pdf.pdf

10.  The most significant growth in minority ◦ Hispanic males who entered medical school this fall- increased by 17.1 percent, while Hispanic female enrollees increased by 1.6 percent from last year. Total Hispanic enrollment was up 9 percent.  The total enrollment for Black/African Americans grew by 2.9 percent over 2009.  The number of American Indians attending medical school is small, this year's enrollees grew by 24.8 percent.  These diversity gains in enrollment were spread across all regions of the country.  The largest increase was in the West, which saw underrepresented minority enrollment grow from 14.4 percent in 2009 to 16.1 percent this year.

11. The AMA estimated the average debt burden for a medical school graduate is $130 571,while the average first-year stipend for a medical resident is $43 266.

12.  Public medical schools ◦ average tuition and fees increased by 7.1 percent for residents, and by 6.3 percent for non-residents from 2009-2010 to 2010-2011.  Private schools ◦ average tuition and fees increased by 4.0 percent for residents, and by 3.6 percent for non-residents during the same period.

13. Level of medical education debt of family medicine residency graduates, 2010

14.  The National Health Service Corps (NHSC), through scholarship and loan repayment programs, helps Health Professional Shortage Areas (HPSAs) in the U.S. get the medical, dental, and mental health providers they need to meet their tremendous need for health care. http://www.hrsa.gov/loanscholarships/index.html http://www.hrsa.gov/loanscholarships/index.html

15.  Eligibility  fully trained primary care physicians (MD or DO)  family nurse practitioners  certified nurse midwives  physician assistants  Dentists and dental hygienists,  certain mental health clinicians  How much  $60,000 to repay student loans in exchange for 2 years serving in a community-based site in a high-need HPSA that has applied to and been approved by the NHSC as a service site.  $170,000 5 Years of Service -  Total Debt 6 or More Years of Service http://nhsc.hrsa.gov/loanrepayment/servelonger.htmhttp://nhsc.hrsa.gov/loanrepayment/servelonger.htm  Where? ◦ About half of Corps members serve in federally-supported health centers ◦ Other approved sites are rural and Indian Health Service clinics, public health department clinics, hospital-affiliated primary care practices, managed care networks, prisons, and U.S. Immigration and Customs Enforcement sites  After completing their 2 years of service, loan repayors may apply for additional years of support. http://nhsc.hrsa.gov/loanrepayment/http://nhsc.hrsa.gov/loanrepayment/

16.  The National Health Service Corps scholarship pays ◦ tuition, required fees, and some other education costs, tax free, for as many as four years.  Education costs ◦ may include books, clinical supplies, laboratory expenses, instruments, two sets of uniforms and travel for one clinical rotation.  Recipients also receive a monthly living stipend ($1,289 in 2010-2011). The stipend is taxable  Obligation ◦ 1 year for each year of support  Where? ◦ Approved sites  rural health clinics, Indian Health Service clinics, public health department clinics, hospital- affiliated primary care practices, managed care networks, prisons, and U.S. Immigration, Customs & Enforcement sites  Salary ◦ Negotiated by the scholar but must be approved  Work schedule ◦ 40 hours/week with at least 32 hours in the ambulatory care setting ◦ Exception is providing OB care http://nhsc.hrsa.gov/scholarship/

17.  The Primary Care Loan program provides long-term, low interest rate loans to full-time, financially needy students to pursue a degree in allopathic or osteopathic medicine.  Loans to third and fourth year students may be increased to repay outstanding balances on other loans taken out while in attendance at that school.  Medical students receiving a Primary Care Loan must agree to ◦ enter and complete residency training in primary care within four years after graduation ◦ practice in primary care for the life of the loan http://services.aamc.org/fed_loan_pub/index.cfm?fuseaction =public.welcome&CFID=1748572&CFTOKEN=68790933

19.  Fully-trained clinicians are eligible for loan repayment in exchange for service in an eligible community. ◦ Air Force http://www.airforce.com/ ◦ Army http://www.goarmy.com/ ◦ Navy http://www.navy.com/

20.  http://www.aafp.org/online/etc/medialib/fmig/do cuments/medschool/dmg.Par.0001.File.tmp/Debt- Mgmt-Guide-updated2-22-11.pdf http://www.aafp.org/online/etc/medialib/fmig/do cuments/medschool/dmg.Par.0001.File.tmp/Debt- Mgmt-Guide-updated2-22-11.pdf

21.  Education  Emergency Medicine and Urgent Care  Inpatient Medicine/Hospitalist  International and Wilderness Medicine  Maternity Care  Multispecialty Practice  Solo vs Group Practice  Research  Public health  Rural vs Urban

22.  83.2% provide inpatient care  78.8 have hospital admission privileges  22.6% do routine OB  22.8% surgical-assist  28.4% perform minor surgical procedures  38.8% delivered care in the CCU  41.1% delivered care in the ICU  44.9% deliver care in hospital ER  57.4% reported delivering newborn care Source – AAFP Facts About Family Medicine. Oct 2006 http://www.aafp.org/facts.xml

23. NMedianMean Total Respondents 1,012$150.0$164.3 Census Division Mid-Atlantic81$140.0$141.4 New England27$125.0$132.5 East North Central171$152.0$161.6 West North Central120$174.0$185.7 East South Central52$177.5$182.5 West South Central100$187.5$210.9 Mountain110$140.0$140.1 Pacific149$150.0$153.0

25. NMedianMean Type of Practice Solo171$150.0$161.3 Two-person partnership 74$160.0$178.5 Family medicine group 324$160.0$169.4 Multi-specialty group 155$160.0$165.0

26.  We must start to identify and mentor our students  Be the resource to keep them interested  Put a positive spin on it  Yes you can pay for your education  They can provide service, do research, choose a specialty, and get an advanced degree  They can teach and become advocates