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What outcomes should we expect from programs that pay physicians'training expenses in exchange for service?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Pathman, Donald E. |
| Copyright Year | 2006 |
| Abstract | NC Med J January/February 2006, Volume 67, Number 1 raining to become a physician is expensive, as the four out of five medical students who graduate in debt will confirm. Young physicians’ educational debt averages over $109,000 and increases by more than $4,000 each year. On the bright side, rising educational costs and students’ fears of acquiring six-figure debts have created a market for government programs that link support for medical training costs to a period of obligated clinical work in physician shortage areas. One of the two most common types of such programs are service-requiring scholarships, which pay tuition and other costs for medical students while obligating them to a period of service that will begin when they complete residency five-to-seven years later (see Figure 1). The other common program type is loan repayment. Loan repayment programs recruit physicians as they complete residency and are ready to begin service in exchange for paying off the traditional education loans they acquired years earlier. Programs of both types typically require one year of service for each year of training cost support they provide. These training support-for-service programs are a seemingly natural solution to both students’ and the public’s needs. They have grown in popularity over the past 25 years in tandem with rising tuition costs, with both federal and state agencies making ready use of them. The National Health Service Corps (NHSC) currently fields an obligated physician workforce of about 1,700 scholars and loan repayers, and the Indian Health Service (IHS) and Bureau of Primary Health Care offer similar, but far smaller programs for physicians to work in Native American and Native Hawaiian communities. Most states also sponsor their own physician training support-for-service programs. There were a total of 69 state programs in 1996 with an estimated workforce of 1,300 practicing physicians. These state programs doubled in number from 1990 to 1996 and very likely have grown further since. After 25 years of growth in these programs, the healthcare workforce advocates who lobby for them and legislators who create and fund them are not completely clear about some of their important aspects, including what outcomes can be expected. Without clear expectations, programs cannot evaluate themselves appropriately or be externally monitored, leaving program failings sometimes unrecognized and opportunities for strengthening programs unrealized. This commentary takes the occasion of this special issue of the North Carolina Medical Journal dedicated to the life and work of Jim Bernstein to review what available research says What Outcomes Should We Expect from Programs that Pay Physicians’ Training Expenses in Exchange for Service? |
| Starting Page | 77 |
| Ending Page | 82 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 16550996 |
| Journal | Medline |
| Volume Number | 67 |
| Issue Number | 1 |
| Alternate Webpage(s) | http://dhss.alaska.gov/ahcc/Documents/meetings/200905/outcomes.pdf |
| Journal | North Carolina medical journal |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
