How one Caribbean medical school helps alleviate the US physician shortage

Healthcare organizations are focused on recruitment and retainment as they face a projected physician shortage and a maldistribution of physicians geographically.

The most updated data from the Association of American Medical Colleges showed the U.S. could face a shortage of more than 121,000 physicians from 2016 to 2030, as well as a potential shortage of 14,800 to 49,300 primary care physicians during that time period.

Additionally, a 2016 Merritt Hawkins white paper cited 6,080 Health Care Professional Shortage Areas for primary care nationwide, 67 percent of which are in rural locations. 

G. Richard Olds, MD, president of St. George's University in Grenada, one of the largest suppliers of physicians to the U.S., believes the physician shortage is real but that maldistribution is the bigger problem.

"I'm not denying there is a primary care shortage and shortage of doctors, but when you look at the [U.S.] numbers, they mask the fact that there's a maldistribution that makes the problem worse if you happen to live in rural America or if you worked in urban, underserved areas," said Dr. Olds, who has served on six U.S. medical school faculties.

"The problem is we don't accept into U.S. medical schools students that come largely from urban, underserved areas or rural areas. That's one of the reasons for the maldistribution of doctors geographically."

International medical graduates come into play when addressing both issues. Research published in 2015 in the Journal of the American Osteopathic Association showed they made up roughly one quarter of practicing physicians in the U.S. workforce and roughly one quarter of specialty residents.The study also found international medical graduates are inclined to work in rural areas and in primary care.

Dr. Olds projects the U.S. demand for physicians will continue to increase exponentially, compounding the projected physician shortage, due to an increasing U.S. population as well as an aging population that will require more medical care.

He said the increase in the number of U.S. medical schools will help address that issue, but he does not believe the increased number of medical students will make up for the increased demand for physicians. "So, in [the] foreseeable future, there will be [a] need to import physicians to meet that need."

St. George's alone placed more than 900 of its medical school graduates into residency programs in the U.S. this year. Out of its medical school graduates, about 75 percent are U.S. citizens and about 25 percent are from other places, such as the Caribbean islands, Canada, Asia and Africa. And, Dr. Olds said, 75 percent of the institution's medical school graduates go into primary care.

While there are many international medical schools, he said St. George's stands apart in how it emphasizes student success. He said St. George's invests heavily in helping students achieve success, meaning the school has more than 40 adults with PhDs who don't teach medical school subject matter but provide study skills and enhanced advising. They also help organize small group study sessions.

"As we move forward, we are fulfilling an important role for [the] country's future by providing well-trained physicians that go into the fields that we really need and actually practice in the areas that we really need and take care of the patients we have a hard time finding doctors to take care of," said Dr. Olds. "And, I think that will only increase in the future as demand goes up."



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