One component of UMMS’s mission is to provide affordable, high-quality medical education to state residents and to increase the number of PCPs practicing in underserved areas of the state.
This study responds to our growing need to recruit future PCPs by investigating differences in relationships with advisors/mentors between those students who pursue a primary care residency and those who do not.
Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2009

Gentile, Gina M.

Kadish, Stacey J.

Pugnaire, Michele P.

Sefton, Laura A.

Zanetti, Mary L.

English

eScholarship@UMMS

University of Massachusetts Medical School eScholarship@UMMS Office of Institutional Research, Evaluation, and Assessment Publications and Presentations Office of Educational Affairs 2009-11-11 Advisor/Mentor Role in Guiding Future Primary Care Physicians Stacey J. Kadish University of Massachusetts Medical School Et al. Let us know how access to this document benefits you. Follow this and additional works at: https://escholarship.umassmed.edu/res_eval  Part of the Educational Assessment, Evaluation, and Research Commons, and the Medicine and Health Sciences Commons Repository Citation Kadish SJ, Gentile GM, Sefton LA, Zanetti ML, Pugnaire MP. (2009). Advisor/Mentor Role in Guiding Future Primary Care Physicians. Office of Institutional Research, Evaluation, and Assessment Publications and Presentations. Retrieved from https://escholarship.umassmed.edu/res_eval/7 This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Office of Institutional Research, Evaluation, and Assessment Publications and Presentations by an authorized administrator of eScholarship@UMMS. For more information, please contact Lisa.Palmer@umassmed.edu. November 11, 2009© 2008 University of Massachusetts Medical SchoolAdvisor/Mentor Role in Guiding Future Primary Care Physicians Stacey Kadish, Gina Gentile, Laura Sefton, Mary Zanetti, Michele PugnaireBackground• In 2006, Massachusetts health care reform law signed, thousands of people were added to the state’s pool of medically insured, many looking for Primary Care Physicians (PCPs) • Both state legislators and professional medical organizations1 agree that the PCP shortage is at a “critical/severe ” level21 Massachusetts Medical Society, Robert Graham Center,  Several state legislators cited in  McAuliffe, Michael (January 4, 2009). 2 Since the time of this study there has been small increases in PCP and the critical level  for some PCP specialties has been downgraded to a “Severe” level , with the exception of family medicine which still remains at a critical level. This according to the Sept. 2009 Massachusetts Medical Society Physician Workforce StudyHealth Care Reform in MassachusettsSelected results:• 440,000  residents are newly insured1• > 97% of all MA residents are insured1• One study found adults now more likely to visit health care providers than before, but now finding difficulty identifying and accessing providers in a timely manner2• In 2007, 1 in 5 adults in MA reported that a physician's office or clinic was not accepting new patients, and the majority (67%) of those reporting these problems were patients seeking primary care specialties21 Massachusetts Medical Society. Physician Workforce Study, 2009 Available at: www.massmed.org/workforce2 Long SK & Masi PB. Access and Affordability: An Update on Health Care Reform in MA, Fall 2008. Health Affairs 28, no. 4 (2009)Current and Previous Research• Graham Report1: found several measurable factors that are related to students choice to pursue a residency in PC: student related factors (rural birth, student intent, marriage status, etc.), institutional factors, (public vs. private, exposure to Title VII funding, strength of family medicine department, etc.), and curriculum factors (family medicine exposure)• Mixed results in studies exploring factors such as student debt/specialty income difference impact on students’ choice of medical specialty1,21 The Robert Graham Center; Funded by the Josiah Macy, Jr. Foundation (March 2, 2009). Specialty and Geographic Distribution of the Physician Workforce: What Influences Medical Student and Resident Choices? Washington, D.C. 2 Harris, Scott. (December, 2008). Graduates Report Higher Debt, Primary care Interest. AAMC Reporter. Available at: www.ammc.org/newsroom/reporter/dec08/graduates.htmUMMS MissionOne component of UMMS’s mission is to provide affordable, high-quality medical education to state residents and to increase the number of PCPs practicing in underserved areas of the state.PurposeThis study responds to our growing need to recruit future PCPs by investigating differences in relationships with advisors/mentors between those students who pursue a primary care residency and those who do not.Primary Care as defined for this study• Family Practice• Internal Medicine• Medicine/Pediatrics• PediatricsAdvisor/Mentor Match Process• First year students fill out form indicating: characteristics of desired advisor characteristics of the student (self) expected specialty choice• Rank order each aspect by importanceAdvisor/Mentor Relationship• Advisors meet variably with students• All advisors are volunteers• 400+ students = approximately 300 advisors• Advisors receive a training guideline packetMethod• Exit survey data analyzed over a five year period (2004-2008, n=499)• Primary Care(n=244) vs. other residencies(n=255)• Four items measuring extent of use and satisfaction with advisor/mentor systemAnalyses• T-test with Bonferroni correction• Proportions analysis using approximation of the binomial distribution (upper & lower ends of satisfaction scale collapsed)Four Variables MeasuredSatisfaction with:*advisor/mentor system for overall guidance and assistance1*advisor/mentor system for guidance and assistance in choosing a specialty1*advisor/mentor system for guidance and assistance in choosing a residency program1Extent of use of the advisor/mentor system at UMMS21 5-point scale: Very Dissatisfied, Dissatisfied, No Opinion, Satisfied, Very Satisfied2 3-point scale: Not at All, To Some Extent, A Lot Proportions Analysis1% Very Satisfiedor Satisfied% Very Dissatisfied or DissatisfiedPC Non-PC PC Non-PCSatisfaction level for overall guidance 83% 71% 10% 19%Satisfaction for guidance in choosing a specialty 75% 63% 10% 17%Satisfaction for guidance in choosing a residency program 78% 61% 5% 22%1 All statistically significant  (p<.05)0 0.5 1 1.5 2 2.5 3 3.5 4Extent of Use**Guidance in Choosing  Residency*Guidance in Choosing  Specialty*Overall*Average Score of Use and Satisfaction with Advisor/Mentor SystemPC Non-PC*1=Very Dissatisfied, 2=Dissastisfied, 3=Neither, 4=Satisfied, 5=Very Satisfied  **1=Not At All, 2=To  Some Average satisfaction levelswith advisor/mentor system PC Non-PCStatistically significant(p<.05)Mean SD Mean SDSatisfaction level for overall guidance 3.9 1.3 3.6 1.4 √Satisfaction for guidance in choosing a specialty 3.6 1.6 3.4 1.5Satisfaction for guidance in choosing a residency program3.6 1.5 3.4 1.5Extent of use of advisor mentor system at UMMS 2.1 0.5 2.1 0.6Satisfaction Scale: 1=Very Dissatisfied, 2=Dissatisfied, 3=No Opinion, 4=Satisfied, 5=Very SatisfiedExtent of Use Scale: 1=Not at All, 2=To Some Extent, 3=A LotDiscussion• Approximately 90% of all students accessed their advisors/mentors with no statistically significant difference between groups• While Non-PC students less satisfied than counterparts with overall guidance, majority (71%) indicated very satisfied/satisfied with overall experience• Majority of both groups very satisfied/satisfied with advisors  in choosing specialty, (PC=75%; Non-PC= 63%), yet this was lowest rating for PC group, indicating potential for improvement • The greatest disparity between the two groups was among satisfaction with guidance in choosing a residencyConclusion• Future PCPs more satisfied than counterparts with advisors/mentors role in guiding their medical career• Direct causation remains unclear• Faculty development should be explored to increase recruitment/retention of future PCPs• Capitalize on relationship between students and advisors**This could build upon a recommendation from the Graham Report (2009), “Support primary care departments and residency programs and their roles in teaching and mentoring trainees.”Reference List • Abdi, Herve. (2007). The Bonferonni and Sidak Corrections for Multiple Comparisons. In Neil Salkind (Ed.) Encyclopedia of Measurement and Statistics. (pp. 1-9). Thousand Oaks (CA): Sage.• Harris, Scott. (December, 2008). Graduates Report Higher Debt, Primary care Interest. AAMC Reporter. Available at: www.ammc.org/newsroom/reporter/dec08/graduates.htm• Massachusetts Medical Society. Physician Workforce Study, 2009 Available at: www.massmed.org/workforce• McAuliffe, Michael (January 4, 2009). Primary Care pulse ‘critical’. The Republican, pp. A1, A8.• The Robert Graham Center; Funded by the Josiah Macy, Jr. Foundation (March 2, 2009). Specialty and Geographic Distribution of the Physician Workforce: What Influences Medical Student and Resident Choices? Washington, D.C. Available at: http://www.grahamcenter.org/online/graham/home/publications/monographs-books/2009/rgcmo-specialty-geographic.htmlContact informationStacey Kadish, MEdEducation Specialist III, Research & EvaluationOffice of Educational AffairsUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcester, MA 01655-0002Tel # (508) 856-5644Fax # (508) 856-5310Email:  stacey.kadish@umassmed.edu

Advisor/Mentor Role in Guiding Future Primary Care Physicians

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Advisor/Mentor Role in Guiding Future Primary Care Physicians

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