Comparison of osteopathic and allopathic medical schools’ support for primary care
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OBJECTIVE: To contrast prevailing behaviors and attitudes relative to primary care education and practice in osteopathic and allopathic medical schools.
DESIGN: Descriptive study using confidential telephone interviews conducted in 1993–94. Analyses compared responses of osteopaths and allopaths, controlling for primary care orientation.
SETTING: United States academic health centers.
PARTICIPANTS: National stratified probability samples of first-year and fourth-year medical students, postgraduate year 2 residents, and clinical faculty in osteopathic and allopathic medical schools, a sample of allopathic deans, and a census of deans of osteopathic schools (n=457 osteopaths; n=2,045 allopaths).
MEASUREMENTS: Survey items assessed personal characteristics, students’ reasons for entering medicine, learners’ primary care educational experiences, community support for primary care, and attitudes toward the clinical and academic competence of primary care physicians.
MAIN RESULTS: Primary care physicians composed a larger fraction of the faculty in osteopathic schools than in allopathic schools. Members of the osteopathic community were significantly more likely than their allopathic peers to describe themselves as socioemotionally oriented rather than technoscientifically oriented. Osteopathic learners were more likely than allopathic learners to have educational experiences in primary care venues and with primary care faculty, and to receive encouragement from faculty, including specialists, to enter primary care. Attitudes toward the clinical and academic competence of primary care physicians were consistently negative in both communities. Differences between communities were sustained after controlling for primary care orientation.
CONCLUSIONS: In comparison with allopathic schools, the cultural practices and educational structures in osteopathic medical schools better support the production of primary care physicians. However, there is a lack of alignment between attitudes and practices in the osteopathic community.
- Council on Graduate Medical Education. Fourth Report: Recommendations to Improve Access to Health Care Through Physician Workforce Reform. Rockville, Md: US Dept of Health and Human Services; 1994.
- Hruby RF. Session II: contemporary philosophy and practice of osteopathic medicine. In: Sirica CM, ed. Osteopathic Medicine: Past, Present, and Future. New York, NY: Josiah Macy, Jr. Foundation; 1996.
- Gevitz N. Session I: the history of osteopathic medicine. In: Sirica CM, ed. Osteopathic Medicine: Past, Present, and Future. New York, NY: Josiah Macy, Jr. Foundation; 1996.
- Cummings M. Challenge to osteopathic education: returning to its primary care roots. JAMA. 1992;268:1139–40. CrossRef
- Singer AM. Debts and Career Plans of Osteopathic Medical Students. Rockville, Md: AACOM; 1994.
- Campos-Outcalt D, Senf JH. Medical school financial support, faculty composition, and selection of family practice by medical students. Fam Med. 1992;24:596–601.
- Martini CJM, Veloski J, Barzansky B, Xu G, Fields SK. Medical school and student characteristics that influence choosing a generalist career. JAMA. 1994;272:661–8. CrossRef
- Colwill JM. Where have all the primary care applicants gone? N Engl J Med. 1992;326:387–93. CrossRef
- Ross-Lee B, Wood DL. Session III: osteopathic medical education. In: Sirica CM, ed. Osteopathic Medicine: Past, Present, and Future. New York, NY: Josiah Macy, Jr. Foundation; 1996.
- Hueston WJ. Factors associated with research efforts of academic family physicians. J Fam Pract. 1993;37:44–8.
- Shlapentokh V, O’Donnell N, Grey MB. Osteopathic interns’ attitudes toward their education and training. Med Educ. 1991;91:786–802.
- Arnstein SR, Haspel LU. A perspective on osteopathic medical schools. Milbank Q. 1994;72:725–33. CrossRef
- Block SD, Clark-Chiarelli N, Peters AS, Singer JD. Academia’s chilly climate for primary care. JAMA. 1996;276:677–82. CrossRef
- Colwill JM, Perkoff GT, Blake RL, Paden C, Beachler M. Modifying the culture of medical education: the first three years of the RWJ Generalist Physician Initiative. Acad Med. 1997;72:745–53. CrossRef
- Block SD, Clark-Chiarelli N, Singer JD. Mixed messages about primary care in the culture of US medical schools. Acad Med. 1998;73:1087–94. CrossRef
- Simon SR, Pan RJD, Sullivan AM, et al. Views of managed care: a survey of students, residents, faculty, and deans at medical school in the United States. N Engl J Med. 1999;340:928–36. CrossRef
- Christianson JB, Hamer R, Knutson D, Wellever A. HMO financial arrangements with rural physicians. J Rural Health. 1997;13:240–52. CrossRef
- Magill MK, Catinella AP, Haas L, Hughes CC. Cultures in conflict: a challenge to faculty of academic health centers. Acad Med. 1998;73:871–5. CrossRef
- Hunt DD, Scott C, Zhong S, Goldstein E. Frequency and effect of negative comments (“bad mouthing”) on medical students’ career choices. Acad Med. 1996;71:665–9. CrossRef
- Comparison of osteopathic and allopathic medical schools’ support for primary care
Journal of General Internal Medicine
Volume 14, Issue 12 , pp 730-739
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- medical school
- primary care
- Industry Sectors
- Author Affiliations
- 1. Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 126 Brookline Ave., 02215, Boston, MA
- 2. Office of Educational Development, Harvard Medical School, Boston, Mass
- 3. Education Development Center, Newton, Mass
- 4. Adult Psychosocial Oncology Program, Dana-Farber Cancer Institute, and the Division of Psychiatry, Brigham and Women’s Hospital, Boston, Mass