Kentucky is facing a doctor shortage. A 2013 report commissioned by the Kentucky Health Benefit Exchange found the state lacks about 3,800 doctors, including 183 primary care physicians. Universities in the Commonwealth are hoping to make a dent in that shortage. Parker Franklin has more on those efforts from Murray State.
Most Tuesday afternoons, a group of 30 or so Murray State University pre-medical students convene in the Jesse D. Jones Hall Chemistry Building. For maybe an hour, they’ll listen to introductions from President FumiNakamura then a presentation by a local medical professional.
One week a physician’s assistant, a neurosurgeon the next.
“We invite these speakers so they can give us their own experiences about how they got to this point, how they got from where we are now to their point in their career,” Nakamura said. “The successful things and the mistakes they made.”
This club, officially known as Pre-Health Professionals, has a somewhat straightforward goal: to educate its roughly 75 members about the industry while also helping them build a résumé for medical school.
However, this club and others like it across Kentucky’s universities play a vital role in solving a problem that’s been brewing for years: as the commonwealth’s physician population ages and more people find coverage, the supply and distribution of new doctors has become inconsistent.
According to a 2013 report commissioned by the Kentucky Health Benefit Exchange, roughly 10,000 registered doctors call the state home. That’s about 3,790 short of meeting demand, including an additional 183 primary-care physicians.
Nakamura said in order to meet that demand, the program prepares the next generation of doctors through community service and shadowing opportunities to portray a realistic view of the medical field.
“A lot of times, you see students who have a 3.0 GPA, which is definitely not going to get you into med school,” Nakamura said. “And then it’s their junior year, they only have another year or so to finish up. I think the biggest hindrance to students without an organization like this is the fact that they don’t understand exactly how rigorous it’s going to be.”
In 2006, the Association of American Medical Colleges called on universities to pump out 30 percent more medical school graduates. Earlier this year, the American Journal of the Medical Sciences reported graduate counts increased 23 percent.
Former PHP President and Murray State University pre-med student Carli Whittington is now in her second year at the University of Louisville School of Medicine and on her way to joining that group. She said barriers for aspiring physicians include a combination of strenuous curriculum and the ever-changing health care industry.
“More people had more access to health care than they had before, but we still had the same number of doctors,” Whittington said.
Whittington purports early education is important to raise awareness of health care careers, but adequate preparation is key to ensuring students come to college ready.
“I think a lot of people come into college with the idea that they want to go to med school,” Whittington said. “But they don’t think enough about it to realize that that’s not really what they want to do.”
This issue primarily manifests itself in the form of retention issues, something Murray State’s pre-med program has faced as of late.
MSU Biology professor and PHP co-advisor David Canning sees about 60 new biology majors with a pre-med focus each year.
“In the first year, we lose 50 percent of our pre-meds and in the second year we lose another 20 percent,” Canning said.
Canning attributes this primarily to program rigor. Generally speaking, the average medical school requires four years of chemistry, two semesters of math, two semesters of physics and a slate of biology courses.
“There’s really no room for electives,” Canning said.
On top of that, Canning claims attracting physicians to Kentucky’s rural areas has proven difficult, largely due to difference in pay and position availability.
A 2013 report from the Medical Group Management Association found that nationwide, primary care doctors earn about $221,000 annually. On the other hand, compensation for specialists topped $396,000.
According to online database Salary.com, primary care doctors in the Louisville area bring home annual pay ranging from $162,939 to $210,554. On the other side of the state, family practice physicians around Hopkinsville earn a median salary of $168,208.
“After med school, to return to a rural situation -Calloway County or Ballard or somewhere like that- you’re not going to be a pediatric neurosurgeon,” Canning said. “A student who’s gone through medical school and comes out $250,000 in debt, they really want to reap the rewards of that investment. And so they tend to go into specialties, which are only really available in big cities.”
While the PHP club primarily works with college students, the partnering Purchase Area Health Education Center also sets its sights on recruiting high schoolers to the industry through health career programs. Director Loretta Maldaner said fostering that interest early on is paramount to raising graduate numbers.
“Our whole focus is to try to get kids from our area interested in health careers and follow them as they go along so that they’ll return,” Maldaner said.
As for college-age aspiring physicians, the PAHEC works with pre-health MSU students through a four-week summer shadowing program. It also conducts clinical rotations for students from the University of Kentucky, Louisville and Pikeville.
Besides experience opportunities, Murray State University’s Pre-Health Professional Advisory Committee helps boost students’ med school applications through group evaluations. Canning, who serves as chair of the nine-member committee, said those evaluations are indispensable for students looking to get into med school.
And in many cases, they’re a required part of the application process.
“It’s the consensus opinion of nine faculty who know the student,” Canning said. “The idea is to get as much input as possible.”
The evaluations cover a myriad of topics including community involvement, work experience and academic performance. To widen their scope, occasionally professors from outside the science departments are brought in to offer their support.
“So we have more than nine members,” Canning said. “We have sort of ad-hoc members for students who request input.”
Those positive evaluations can often make the difference in a successful application. According to PHP co-advisor Ricky Cox, about 50-52 percent of Murray State pre-meds get into medical school compared to a national average of 42 percent.
As for possible methods to bolster rural Kentucky’s understaffed facilities, a western Kentucky doctor’s research suggests simply increasing the number of graduates won’t make a difference.
University of Louisville School of Medicine Trover Campus Dean Dr. Bill Crump and his colleagues studied 1,120 physicians from UL between 2001 and 2008. Of that number, 45 percent of med school graduates that finished their training in rural campuses went on to practice in a rural setting, compared to just seven percent that remained in urban areas.
The research used control methods to account for graduates that grew up in rural areas. Crump said his team successfully proved campus location alone played a major factor in a doctor’s chosen location to practice.
Back in MSU’s chemistry building after the latest meeting, Nakamura said programs like the Pre-Health Professionals are an important guide for students considering investing themselves in Kentucky’s doctor workforce.
“For some people, it’s really a question of ‘Is this going to be worth it?’” Nakamura said. “That’s the kind of thing that we’re trying to help them figure out.”
