CLEVELAND – We are medical students from Northeast Ohio with a passion for family medicine. We include two student directors of the Ohio Academy of Family Physicians Board of Trustees, several student delegates to the American Academy of Family Physicians, a Pisacano Fellow, and a National Health Service Corps Fellow.
A few weeks ago, we learned that University Hospitals chose to end her family medicine residency program at Cleveland Medical Center after graduating current cohorts. In response, we sent the UH administration a letter of protest that garnered more than 200 student signatures.
The culture surrounding generalism in specialized, research-oriented institutions is often neither encouraging nor positive. Attending physicians, professors, and peers told us that we should aim beyond family medicine or that we would likely change our minds as we progressed through medical school.
But we all choose primary care for the satisfaction that comes from the personalization and integration of holistic care for the person and their entire life. We understand the risks of practicing primary care, including burnout, overwork, and being undervalued in a fee-for-service “patient care” system that places procedures and profits before prevention and people. As our awareness of this gap in critical care deepens, our drive to become physicians to meet this need only intensifies.
The termination of the UHCMC FM Residency (FMR) demonstrates disinvestment in primary care, with detrimental consequences for the Cleveland community and the medical community, including students, trainees, and attending physicians. Among them:
· Impact on the community: The FMR plays a central role in addressing health disparities among marginalized populations. Closing this program disproportionately hinders access to care for underserved communities that rely on residents and faculty for quality health services. We believe Ohio’s medical institutions have a responsibility to address, not exacerbate, gross inequities in primary care in the communities they serve.
· Impact on the medical professional community: Closing this training program exacerbates the need for primary care physicians to train and stay in Ohio, a state projected to have a shortage of 700 primary care physicians by 2030. This places an undue burden on colleagues in other departments and neighboring institutions because, unlike pediatrics, In internal medicine and obstetrics-gynecology, family medicine is the only primary care specialty that can and will care for the entire family, from birth to death. Northeast Ohio’s health care infrastructure will surely feel the devastating effects of a primary care shortage as fewer residents are trained and fewer family medicine faculty are recruited.
· Impact on local medical students: Closing the residency program impacts the training, culture, and specialization of medical students by sending a message to students that family medicine is not valued by the institution. This will discourage students from pursuing careers in primary care, an already struggling field. Also not to be overlooked is the fact that residents serve as highly engaged mentors and teachers in the academic and extracurricular activities of Northeast Ohio medical students, which is essential in forming a positive perception of family medicine.
We hope that academic medical institutions will be attentive and responsive to the needs of our community, region, and state. We request two actions: 1) That UH communicate its decision to all patients, faculty and students recognizing these groups as stakeholders, and 2) That UH commit to reinvesting in family medicine, demonstrating a renewed dedication to primary care, to trainees. and patients, in Northeast Ohio.
Hannah Hutchinson Clarke has a master’s degree in public health and is a third-year medical student at Case Western Reserve University (CWRU). She is interested in family and preventive medicine, adolescent health and will one day work in a government health agency. Olivia Mangat Dhaliwal is a fourth-year medical student at CWRU, eager to embark on her journey to becoming a healer in her own right in rural America. She advocates nationally for rural and family medicine. They are joined in this opinion piece by Carlee Mitchell, Ellen Hutchinson, Trina Pal, Andrew Halza and Anirudh Prabu, all third-year medical students at CWRU.
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