Council on Medical Student Education in Pediatrics

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COMSEP Meeting in Ottawa, ON

Poster Presentation:


The Sustainable Voluntary Preceptor in Primary Care Pediatrics: are financial incentives meaningful?

Authors:
Christine R. Connelly,,Atlanta,Georgia,David D. Lloyd,,Atlanta,GA,Eric I. Felner,Emory University,Atlanta,GA

 

Background:  Since 2009, junior medical students from Emory University have learned ambulatory pediatrics from community pediatricians in the metro Atlanta area who are chosen by Emory faculty. The pediatricians devote nearly 100 hours per student of unpaid one-on-one teaching. They follow a teaching curriculum for ambulatory pediatrics that includes goals and objectives outlined by the Pediatric clerkship director.

 

There are over 500 general pediatricians in the metro Atlanta area. Due to decreased reimbursement, pediatricians are forced to see more patients in less time, thus reducing teaching time. Therefore, it has become extremely challenging to recruit and maintain an adequate number of pediatricians to consistently teach ambulatory pediatrics to our junior medical students.

 

The State of Georgia recently passed a state tax credit incentive for primary care physicians who spend 360 hours per year teaching Georgia medical students.  The tax credit provides approximately $8.50 per teaching hour.

 

Objective: To determine if a financial incentive would motivate pediatricians to teach, or if already teaching, to increase their teaching load of junior medical students from Emory University. 

 

Methods: 65 private practice pediatricians in the metro-Atlanta area were surveyed by email. In addition to demographics, pediatricians answered questions regarding responsibilities, desire, barriers, and attraction of a financial incentive (and how much) in teaching junior medical students. An unpaired student t-Test was used to compare continuous variables and the chi square test was used to compare categorical variables between current preceptors versus non-preceptors.

 

Conclusions:   Lack of time to teach (and not financial compensation) is the overwhelming challenge that most private practice pediatricians report.  A financial incentive would encourage 55% of active preceptors to teach more frequently but would encourage only 48% of the non-teaching pediatricians. For pediatricians who desired a financial compensation, most elected to receive between $5-10/student/hour. Therefore, the new tax credit offered to primary care physicians in Georgia does not appear to be a significant factor in increasing the number of pediatricians volunteering or increasing their time teaching to junior medical students at Emory University.

 

Parameter

Preceptors

Non-Preceptors

P-value

Total Number of Pediatricians Responding

      Always Precept

      Consistently Precept

23

   3

   20

25

   0

   0

------

Gender

11 M/12 F

13 M/12 F

NS

Years in Practice (Mean)

23.9 ± 10.7

17.6 ± 11.5

NS

Preventing Barriers

       Time

       Money

       Interest

20

  20

    0

    0

25

  23

    1

    1

NS

Monetary Incentive Would Encourage

11

11

NS

Amount of Incentive ($/student/hour)

        < 5

5   – 10

> 10

 

3

6

2

 

3

7

2

NS

 

References:

 

  • Recruiting and Maintaining U.S. Clinical Training Sited: Joint Report of the 2013 Multidiscipline Clerkship/Clinical Training Site Survey.
  • Stirling, J –Community Pediatric Faculty – A Valued but Endangered Resource.  AMSPDC notes 2014; 165:220-21