As health reform was being debated in Congress and the media, medical students were silent. Students, too busy with memorizing the minutiae of medicine, were unable to fully participate in a debate that, at its heart, has some of the greatest implications for their training, careers, and future patients. Students who were able to speak up stood on far sides of the ideological spectrum of reform—debates often ran hot as proponents and opponents of reform battled it out in my lecture halls at Johns Hopkins. And though not all seem pleased with what came from Congress on March 23, 2010, we have the Patient Protection and Affordable Care Act.
To catch all of my fellow students up with the results of health reform, I am using this blog post to briefly outline the more pertinent features of health reform that affect our medical school and residency training:
Undergraduate Medical Education:
There are no provisions within PPACA that directly impact undergraduate medical education. Though PPACA does not affect undergraduate medical education directly, it does encourage students to pursue careers in primary-care and preventive medicine. As more individuals become insured through PPACA, primary-care and preventive medicine specialties will be in greater demand; something to consider when choosing residency programs. So take a breath and calm down. Focus on discovering what you’re passionate about in medicine.
Graduate Medical Education:
This is where the bulk of the PPACA provisions will impact medical students indirectly and residency trainees directly. A number of provisions encourage doctors in training to pursue primary-care and general surgery careers, particularly in rural and other underserved areas, through such programs as the National Health Service Corps. Those provisions include expanded loan and debt-forgiveness options and more money for community health centers, where many primary-care residents train.
Following the adage that “an ounce of prevention is worth a pound of cure,” the PPACA provides incentives for medical residents to pursue training in preventive medicine and public health, through such programs as the Public Health Workforce Loan Repayment program.
Additional incentives lie in the Medicaid provisions of PPACA, but that can be discussed later.