The medical education system encounters a bottleneck in efforts to increase the supply of doctors, so some states have created financial incentives to attract practicing physicians to serve as student advisors.
Too few doctors are willing to oversee medical school rotations, limiting class sizes and the number of new doctors trained in the field. The unpaid nature of this job is one reason why.
Seven states have responded by instituting tax incentives worth up to $10,000 a year for physicians taking on the responsibility of helping train the next generation. These programs improve medical training and reinforce health education, said Denise Kornegay, associate dean at Georgia’s Augusta University College of Medicine and executive director of the Georgia Statewide Regional Center for Health Education. clinical system.
Kornegay spearheaded the task of enacting the nation’s first tax incentive for precepts in Peach State nine years ago. Colorado, Hawaii, Maryland, Missouri, Ohio and South Carolina followed suit.
Since the Georgia program launched in 2015, nearly 3,000 physicians have signed up, according to the Georgia Preceptor Tax Incentive Program. Many come from rural or low-income communities or run independent activities, which is important to match students with pathways that align with their interests and long-term goals, Erica Sutton, associate dean of academic programs at Morehouse School of Medicine in Atlanta.
“The result that students see is a more diverse exposure to the different kinds of practice opportunities they might want in their careers,” says Sutton.
How do state tax incentives compare?
In Georgia, participating physicians can receive a $1,000 tax credit per student, with a maximum annual incentive of $10,000. Colorado offers a $1,000 tax credit to doctors in rural communities. Maryland offers up to $10,000 a year to doctors in underserved areas. In Ohio, eligible federally qualified medical centers can collect up to $50,000 annually for graduating students. In Missouri, registered family physicians, internists, OB-GYNs, paediatricians and psychiatrists will be eligible for up to $3,000 a year when the law went into effect last year.
student support
Medical schools establish clinical training placements through partnerships with hospitals and associations with independent practitioners. However, recruiting enough doctors to serve as teachers is a barrier, Sutton said. Some doctors are uncomfortable taking on teaching roles, she said. Others struggled to get it: Training medical students takes time and can cut down on a doctor’s ability to see patients.
Before the COVID-19 pandemic, 84% of medical school principals were concerned about the number of secretarial positions available to students, especially in primary care, according to survey results by the Association of Medical Colleges US announced in 2020. More recently, staffing shortages, burnout and economic headwinds have exacerbated the problem.
In Georgia, competition is fierce between in-state and out-of-state medical schools for clinical training locations, says Sutton. Most medical schools in the state have been unable to scale up class sizes to meet supplier shortages due to lack of training opportunities, Kornegay said.
“We have this growing demand in a very competitive market,” says Kornegay. “We need to encourage teachers to accept Georgia students from Georgia programs.”
Kiyana Harris, who will graduate from the College of Osteopathic Medicine of Philadelphia in Suwanee, Georgia, later this month, said it’s important for medical schools to increase the number of mentoring opportunities available, especially for students members of ethnic minorities and people with difficult circumstances.
Harris, 30, grew up in public housing in the South Bronx neighborhood of New York City, one of the most socially vulnerable communities in the nation. Harris said she has always felt supported to pursue her dream of becoming a doctor, but lacks the resources that others possess. Many of the students she is competing with have a family doctor directly instructing them or they receive professional assistance in filling out the application.
“There are no doctors in my family and no one ever said to me, ‘This is what you need to do if you want to be a doctor,'” Harris said.
When Harris first tried to get into medical school, every institute she applied to turned her down. The same thing happened on her second attempt. Determined, Harris seeks a master’s degree and attended a medical tour of Belize, where she volunteered at a free clinic to make herself a more attractive candidate. She also works full-time to cover living expenses and save on costly application costs. When Harris applied to medical school for the third time, she held her breath.
In July, Harris will begin a psychiatric residency program at Morehouse School of Medicine, where she hopes to focus on racial disparities in mental health. She said her journey through medical school has been turbulent. Harris carries a considerable amount of debt, and she feels inferior to her colleagues, who all seem to have had contact with the medical field. In contrast, her memories of the health care system include bus rides to Manhattan when she was sick and scary trips to the hospital when her mother was seriously ill.
Harris said medical schools can better support people like her—a Black woman who grew up in poverty—by providing opportunities to help them adjust. “We need mentors and people in places you want to go because there’s no one who looks like me as a doctor. I really don’t have anyone to talk to about these things,” she said.
Doctor’s point of view
Dr. Samuel Church, a family physician in rural Hiawassee, Georgia, has been training medical students for over 15 years. Until recently, he did it for free. “The amount of my teaching makes no sense from a business perspective, but we have to educate these students,” he said.
The church typically supervises one student every six alternate weeks. Although credit doesn’t cover all costs, he says, it makes it more viable.
“There’s a lot of practice and really great doctors and mentors who just can’t stand the slowdown the students bring,” says Church. “The tax credit doesn’t cover all of that, and the list of intangibles that come with teaching is long, but the tax credit removes only one of those barriers.”
Dr. Joseph Flaherty, president of Western Atlantic University in the Bahamas and former dean of admissions at the University of Illinois School of Medicine at Chicago, said state tax credits are welcome, but cautioned that those Such incentives could dilute the learning environment if doctors take on more students per rotation. The best training environment, he says, is usually two students per doctor.
Since Georgia enacted the tax credit, Kornegay said, doctors who previously instructed two students per rotation are now taking on four or five. Credit is also attracting new doctors to the physician network. She said that last year alone, more than 200 trainees signed up for the training.
“That’s pretty astronomical,” Kornegay said.
