Are Newly Trained Medical Residents Ready for Rural America?

Have you ever wondered whether newly trained physicians have the right skills, knowledge and attitudes to practice intoday’s healthcare environment? More specifically, have you wondered if they are prepared to practice in a rural setting?

A new study answers the former question. While it does not specifically address the issue of readiness to practice in rural America, it does address many issues which are of critical importance to healthcare in rural settings. The study explored the responses of 73 department chiefs in four clinical departments (general surgery, internal medicine, obstetrics/gynecology, and pediatrics) in the Permanente Medical Group in Northern California.  Thus, there are questions of how representative this sample is of all physicians in America but there are still lessons we can learn from this study. It would be interesting to repeat this survey with a nationwide sample of medical residents.

Overall, the study results are not encouraging. According to these department chiefs, newly trained physicians have deficiencies in many areas. Some of these deficiencies are worrisome for rural health in particular. Here are some of these identified deficiencies:

• “…newly trained physicians were often unprepared for the professional interactions involved in multispecialty practice.”
• “Another commonly noted deficiency in newly trained physicians was a lack of familiarity and comfort with managing chronic health care conditions in office-based practice.”
• “The survey respondents worried that some newly trained physicians enter the profession with the idea that their job is one with fixed hours.”
• “…residency training does little to expose young physicians to the actual costs of care delivery, methods of avoiding duplication and waste, or the impact of health care costs on the relative affordability of health care coverage.”

If you were designing medical residency programs to ensure that the next generation of physicians is prepared to practice in rural America, what would you like to see included in these programs?

For more information on this study, go to: http://content.healthaffairs.org/content/30/11/2142