Exploring the Social Mission of Medical Education

There is no question that the U.S. needs more primary care providers and doctors who can meet the health care needs of underserved communities and populations. But what are medical schools doing to address these problems? 

Medical schools play a significant role in determining the make-up of the U.S. physician workforce Where doctors choose to work and what specialty they select can be heavily influenced by medical school experiences. Medical schools also can influence the diversity of physicians who practice so that they reflect patients who need care. 

Meeting a Social Mission 

To what extent medical schools are meeting their social mission was the focus of a study funded with $750,171 in support from the Macy Foundation Dr. Fitzhugh Mullan and colleagues from the George Washington University examined the record of the nation’s 141 medical schools in graduating physicians who practice primary care, work in underserved areas, and are minorities. The researchers ranked medical schools on their ability to meet these three measures, combined into a composite “social mission” score and found wide variations among the institutions. 

Specifically, the study found that: 

  • Medical schools in the Northeast generally performed poorly on all three measures and, as such, had the lowest social mission scores. 
  • Public medical schools graduated higher proportions of primary care physicians than their private counterparts. 
  • Schools with substantial National Institutes of Health research funding generally produced fewer primary care physicians and physicians practicing in underserved areas, and thus had lower social mission scores overall.
  • Several large research institutions (notably the University of Minnesota and University of Washington) defied this trend, ranking in the top quartile for overall social mission score. 
  • Historically black schools had the highest social mission scores. 
  • Osteopathic schools produced more primary care physicians than allopathic schools but trained fewer minorities. 
  • Schools in progressively smaller cities produced more primary care physicians and physicians who practiced in underserved communities but graduated fewer minorities. 

Where Medical Schools Go From Here 

It is understood that medical schools have multiple “social missions” that include training of specialists, generating new knowledge and serving their local communities. However, study authors say the results can help schools assess their graduate patterns in the context of the country’s current health care needs and learn from one another about steps they can take to improve recruitment and admission policies, curriculums and culture. 

The study also generated extensive coverage in national and regional print and broadcast media, as well as widely read blogs, sparking a lively dialogue about the social mission of medical education and how medical schools are helping meet society’s health care needs. 

From the coverage: 

“The study is a wake-up call to medical educators, medical students, practicing physicians and society in general. While this “social mission” isn’t the only mission of medical schools, it is an important one. Of course we want high-end research to continue in medical schools. Of course we want cutting-edge specialty care to proliferate. But medicine is unique in that it possesses a social mission and it’s clear that as a profession we are falling behind in this area.” - Danielle Ofri, MD, PhD, associate professor of medicine at New York University School of Medicine, writing on CNN’s health blog The Chart

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