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Encouraging Medical Students to Choose Rheumatology

Encouraging Medical Students to Choose Rheumatology

Facing a growing shortage, rheumatology is looking to attract the next generation of providers. 

Rheumatology Network spoke with Marcy Bolster, M.D., from Massachusetts General Hospital, about sparking interest among fellows, as well as other providers, including nurse practitioners and physician assistants. Dr. Bolster, director of the Rheumatology Fellowship Training Program at Massachusetts General Hospital, spoke on “The Role of Graduate Medical Education in Adult Rheumatology" at ACR 2016.  Marcy B.Bolster, M.D.Marcy B.Bolster, M.D.

Rheumatology Network:  What constitutes accelerated attrition among rheumatologists?

Dr. Bolster:  About 50 percent of the workforce plans to retire by 2030 and meanwhile, the demand for rheumatologists will continue to rise. And as they prepare for retirement, these physicians predict they will see 25 percent fewer patients as they scale down. 

Rheumatology Network:  What does reduced productivity look like?

Dr. Bolster:  It’s multifactorial. It’s not only retiring physicians seeing fewer patients. When you examine our workforce from 2005, the field shifted from being male-dominated to approaching equality. By 2030, rheumatology will be 58 percent women, and they see fewer patients than men. The millennial generation will also account for more, and data shows they see fewer patients than their older counterparts. Rheumatology-fellow data revealed between 18-20 percent plan to work part-time, with 90 percent being women. So, we’re seeing workforce shifts of gender, age group and retirement rate. We’re also seeing large numbers of international medical graduates, between 15-20 percent, who predict they will leave the U.S. to practice in their home country. We must prepare for this huge shift. 

Rheumatology Network:  What incentives exist to prompt students to choose rheumatology?

Dr. Bolster:  We need more incentives. Rheumatology doesn’t have a big medical school presence. Students get more cardiology, gastroenterology, pulmonary and hematology/oncology exposure. Part of the goal is increasing exposure so they discover how much fun rheumatology is and realize they’d like to pursue it. 

We don’t have anything in place right now for fellows. The data shows fellows have student loan debt, so repayment programs would help. Incentives could encourage international medical graduates to stay here. Another option is looking at the nationwide rheumatologist maldistribution. Some states have no providers and no training programs, so we could benefit from incentives for rheumatologists to work in under-served areas.

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