Chronic shortage of training sites worries medical schools

The Association of American Medical Colleges (AAMC) says many of its members are worried about a shortage of training sites for students and residents.

The AAMC’s 2016 Medical School Enrollment Survey found that 80% of schools were concerned about the number of available clinical training sites. There were also issues with the numbers of primary care and specialty preceptors.

The graphic below shows that these problems are not new, but in general seem to be worsening. [Click on the figure to enlarge it.]

The situation is exacerbated by increasing competition for clinical sites from osteopathic schools, offshore medical schools, and nurse practitioner and physician assistant schools.

Contradictory evaluations cause trouble, consternation

Two weeks ago I blogged about a resident who had been told she must repeat her fourth year of training. She countered with a lawsuit claiming that the surgery department and the medical school did not follow their policies in mandating her remediation.

She said written evaluations by faculty during her fourth year of residency were generally very good, but some oral feedback she received was negative.

From my experience as a surgical residency program director, I know inconsistent, vague, and unhelpful evaluations from faculty are common. For example, a medical student on Twitter recently posted the following:

The tweet prompted many comments from others; the best of which are these [names changed]:

That he seems well read and has a good depth of knowledge deprives him of good learning opportunities.

John sometimes stands too close when he presents. 3 months later. I don't understand why John stands so far away when he presents.

Tends to scare off new people./Makes everyone feel welcome & appreciated.

Dr. Doe, don't be too hard on the juniors. One week later. Dr. Doe, don't be too friendly to the juniors.

And my favorite

Jane should be aware of how she holds her shoulders. It changes the energy in the room.

Do you have similar evaluations to share?

Thanks to Natalie Wall (@nataliemwall) for allowing me to use her tweet.