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Medical school mission statements may influence graduate student outcomes, Upstate study finds

Medical school mission statements may influence graduate student outcomes, Upstate study finds

SYRACUSE, N.Y.-- Medical schools whose mission statements underscore societal good and a desire to train students for service to at-risk populations are more likely to produce physicians who will enter careers in primary care (such as family medicine) and work in medically underserved areas, according to a study by Upstate Medical University researchers published in the June issue of the journal Family Medicine.

Researchers in Upstate’s Department of Family Medicine, led by Christopher Morley, PhD, associate professor of family medicine, public health policy and psychiatry, asked a panel of stakeholders from various medical schools (administrators, faculty, students) to rate the degree to which each medical school mission statement reflected or recognized a social mission of medical education. Mission statements from every U.S. medical school were assessed.

The researchers defined social mission content as “any language that reflects a goal of medical education to train practitioners capable of matching the needs of society and vulnerable populations or for the institution itself to serve vulnerable populations or regions.”

Mission statement ratings were then matched with graduate student outcomes. Researchers found that medical schools with mission statements rated highest for social mission appear to have a greater percentage of graduate students entering family medicine and working in under served areas.

“Producing physicians who enter service-oriented careers like family medicine or work in under served care areas of rural environments is not an accident,” Morley said. “Mission statements are a proxy for an institution’s commitment to service and the greater social good.”

The need to increase the ranks of primary care physicians, which includes family medicine, is significant, as indicated in the 20th Report of the Council on Graduate Medical Education. That report noted that optimal health care outcomes and efficiencies are greatest when at least 40 to 50 percent of the physician workforce is composed of primary care physicians.

“Unfortunately, interest in primary care among new physicians is decreasing rather than increasing,” Morley noted. “If medical schools wish to address flaws in the distribution of primary care physicians or physicians who go on to practice in under served communities, then they must be willing to think about the issues comprehensively; this includes decisions about whom to admit how to educate and train those admitted, how to maintain student idealism over the course of training and how to reduce the debt burden of medical education.”

Morley said one solution to address these issues would be to reexamine a school’s mission statement, because such an undertaking can “help galvanize the energy and focus needed to encourage decisions that will increase primary and underserved care placements among medical school graduates.”

“The mission statement is the canary in the coal mine and it does reflect the broader institutional culture, especially as it relates to social good,” Morley said.

In addition to Morley, other study authors are Emily Mader, MPH, MMP, and medical student Timothy Smilnak of Upstate Medical University; Andrew Bazemore, MD, MPH, Stephen Petterson, PhD, of the Robert Graham Center; Jose Rodriguez, MD ,and Kendall Campbell, MD, of Florida State University’s Center for Underrepresented Minorities in Academic Medicine, and Department of Family Medicine and Rural Health.

Caption: Professor Christopher Morley, PhD, left, is lead author on the medical school mission statement study, which was published in a recent edition of the journal Family Medicine. Coauthors, also from Upstate Medical University are, from left, Emily Mader, MPH, MMP, and medical student Timothy Smilnak.