Clinical Site Shortages
In 2006, the AAMC recognized that the United States was facing a physician shortage. They recommended a 30% increase in medical enrollment from the numbers in 2002-3 by the 2015-16 school year. While this goal was not met on time, it has since been surpassed (Boyle, 2020). However, as medical school enrollment has grown, so have the challenges of placing students in clinical sites, meaning that fewer spots are readily available for more students.
If schools cannot place their students into clinical rotations and residencies, this increase in enrollment will not be able to help the physician shortage; the clinical portion of medical education is crucial, and physicians cannot be sent into the workforce without it. Schools are aware of this issue; in 2020, 84% of schools were concerned about finding enough clinical rotation sites with 86% worried about finding qualified primary care preceptors (ibid).
This disparity is due to a number of reasons. The shift from inpatient to outpatient treatment has meant that schools can less often expect full-time hospital faculty to be available to oversee students. Physicians have heavier workloads and less freedom to choose to allot time to teaching. Clinical education for medical professions across the board has grown, meaning that it is not only medical students taking spots but physician’s assistants, nurses, etc. Offshore schools now often pay to place their students in training sites in the continental U.S., adding even more students into the pool to be placed. The COVID-19 pandemic exacerbated the issue even further by placing greater demand on medical staff throughout the country (Howley, 2020).
Schools are struggling with how to respond to this issue. At this point, most schools are not paying preceptors, but 44% feel pressured to do so (ibid). Other possible solutions include creating new clinical sites, either by expanding regions or creating community-based health centers; offering remote options, such as watching physicians work via video; and collaboration between programs. Governing bodies can help by offering tax credits to preceptors or by offering continuing education credits. Finally, schools can incentivize preceptors by making the job as easy as possible (training students well before sending them to the site, providing PPE, etc.), expressing appreciation through gifts or other means, and offering perks to preceptors such as library access (ibid).
Organized, streamlined performance assessment can help with alleviating the burden placed on preceptors. A high-quality software system, such as eValuate+, offers reminders and easy-to-use forms, making it easier for preceptors to offer feedback on clinical performance. The system can also make managing preceptors easier, as it can track licenses and documentation, track hours if programs decide to pay preceptors, store notes from preceptors to students, process preceptor applications, and much more. Given that the placement of students into clinical sites is such a leading issue for many medical education programs right now, having a high-quality software system to support students, faculty, administrators, and preceptors can be a key asset in managing the clinical education process.