Residency expansion increasing physician footprint
Efforts to expand graduate medical education—necessary to help address Indiana’s statewide physician shortage—are moving forward with the new Indiana University School of Medicine Arnett Family Medicine Residency Program training its first medical school graduates in Lafayette. In total, 15 positions were approved for IU Health Arnett with the first five residents starting their three-year program in 2018.
Indiana ranks 43rd nationally in the number of medical trainees (residents and fellows) in programs approved by the Accreditation Council for Graduate Medical Education (ACGME). The national average for the number of medical trainees per 100,000 population is 28, with Indiana trailing most other states with just 22. In comparison, states with large numbers of medical schools—like New York and Massachusetts—have as many as 80 trainees per 100,000 population.
Lower numbers of residents correlate to shortages in the number of practicing physicians, a situation the Indiana General Assembly aimed to address when it created the Indiana Graduate Medical Education Board in 2015. Comprised of leaders in medical education (including Indiana University School of Medicine), representatives from Indiana physician groups and health care systems, and Indiana State Medical Association leadership, the board funds and supports the addition of new residency programs across the state. With Indiana currently lacking 424 trainees to reach the national average, the board’s initial goal is to reduce the gap to 234 by 2024.
The new IU School of Medicine Arnett Family Medicine Residency Program is the first IU resident training program launched since the state’s GME board was formed and the first established outside the Indianapolis metropolitan area. ACGME accreditation has also been granted for five family medicine residency positions per year for a three-year training program at Memorial Hospital in Jasper, and four psychiatry positions at Good Samaritan Hospital in Vincennes for each year in a four-year training program. These two programs will begin training medical school graduates in July 2019.
“Nationwide, there’s about a 50 percent chance a doctor training in a location will practice in the location where he or she trains, and fortunately for Indiana, our state has been more successful than most in retaining physicians,” said Stephen Cico, MD, MEd, assistant dean for graduate medical education, IU School of Medicine.
“Through residency training, physicians come to know the system, the community and the patient population, as well as their peers, making it both advantageous and easy for them to want to stay.”
Working with the Graduate Medical Education Board to decrease state physician trainee shortages in primary care, psychiatry, emergency medicine and surgery, IU School of Medicine has led feasibility studies for new training programs across the state, analyzing key factors such as community need, faculty and teaching resources, and patient volume to ensure the potential programs will meet ACGME residency requirements.
These studies, along with the formation of a consortium of hospitals in southwestern Indiana, have paved the way for the residency programs in internal medicine and psychiatry recently approved there. A feasibility study is underway to locate an emergency medicine residency program in Bloomington, and adding other training programs in the Bloomington area is also being considered.
While IU School of Medicine is the only school in Indiana granting the doctor of medicine (MD) degree, Cico says the school’s nine regional campuses offer a unique opportunity to expand graduate medical education statewide.
“There aren’t many medical schools developing residency training programs throughout an entire state, so we’re leading the way with this expansion model,” Cico said.
Leaders of the new residency program at Arnett—a joint venture between IU School of Medicine and IU Health Arnett—are excited about the program’s potential to attract medical school graduates to the region.
“We view this as an opportunity to invest in a program where we are involved in training residents that we can possibly hire to serve in our communities,” said Kishan Patel, MD, associate program director of the Arnett residency program, who has been with IU Health Arnett since 2006.
Patel added that in its first year, the Arnett Family Residency Program received 1,000 applications for five residency positions, doubling initial projections.
“As one of the first community-based family medicine residency programs sponsored by IU School of Medicine, we’ve designed an innovative curriculum focusing on the skills and tools primary care physicians need to contribute to today’s outpatient healthcare model.”
One of the first five residents at Arnett, Nicole Moon, DO, a graduate of the Marian University College of Osteopathic Medicine, recognizes the benefits of being involved in this new residency program.
“From the very beginning of the interview process, I quickly learned how motivated the faculty and organizers are to make this family medicine residency program really strong,” Moon said. “In addition to being supported by IU and IU Health, this program offers unique curricular strengths and support to enable residents to meet their individual career goals.”