New study on NYU primary care residency program indicates low burnout rates and career satisfaction

NYU Langone Medical Center released today the findings of a study on the New York University/Bellevue Primary Care Internal Medicine Residency Program (Bellevue/NYU PC Program), published in the November 2008 issue of Academic Medicine. This 23 year assessment of an extraordinary educational approach to residency training outcomes documents a unique educational approach, which has resulted in high personal and career satisfaction of residents and lower burnout rates – close to one third of that of their peers.

The study, "Two Decades of Title VII Support of a Primary Care Residency: Process and Outcomes," may provide an answer to how to correct the imminent shortage of primary care doctors that medical associations and industry experts predict. It also supports a positive outlook for the future of primary care. The survey finds that 87% of the Program's graduates practice as primary care physicians, 83% teach, 90% work with the underserved, 54% engage in research, 36% actively advocate on health issues and 30% publish research.

"As demonstrated in this study, our primary care program represents a different and more evolved paradigm of education with a strong emphasis on three pillars of primary care, psychosocial medicine, evidence based approaches to care and knowledge of health policy and systems," said Dr. Mack Lipkin, the lead investigator and Professor of Medicine and Co-Director of the Primary Care Internal Medicine Residency Program. "By training our doctors to be able to manage aspects of human care in an expert and caring manner, we transform what is frustrating to most doctors into an aspect of practice that is deeply rewarding."

Many experts agree that primary care should be the backbone of any healthcare system. Countries and/or states with a robust primary care system often yield better health outcomes at lower costs compared to those countries and states with weaker primary care systems, such as the United States. However, medical students are often dissuaded from entering the field of primary care because of the dysfunctional payment systems and salary disparities, unbalanced emphasis on specialized medicine in medical schools, inability to establish long-term patient relationships and the ongoing challenge of addressing a broad scope of health issues. Recent reports also suggest that the quality and efficiency of health care is at risk when primary care is neglected.

"The fact that these trainees enter primary care practice is a testament to the skills and attitudes instilled by this program, which continue to shape and influence clinical practice and medical education on a national level. By crafting an educational, training model that is comprehensive in scope and focused on top priorities, the Bellevue/NYU PC Program has produced high numbers of primary care physicians who are actively engaged in scholarship, demonstrate low burnout rates and high career satisfaction and who are engaging in the type of medicine that our country needs. This program has been and will be instrumental in raising the level of sound primary care in the United States," Dr. Lipkin added.

One former resident described their training at the Bellevue/NYU PC Program as a "soul-nourishing and sanity-restoring" experience that expanded her view beyond the parameters of biomedicine. Participants also stated that their training imparted a new understanding of their role in society and in the world at large.

The study, Two Decades of Title VII Support of a Primary Care Residency: Process and Outcomes, is led by Dr. Mack Lipkin, Professor of Medicine and Co-Director of the Primary Care Internal Medicine Residency Program. The evaluation consists of a comprehensive quantitative and qualitative survey of 122 reachable graduates from the first 20 graduating classes of the program. With an 85% response rate, 104 graduates participated in the survey. The evaluation also included an analysis of program documents, which included eight Title VII TPCMD grant applications, proposed and implemented curricular innovations, residency evaluations, retreat summaries and performance-based assessments.

Located in the heart of New York City, NYU Langone Medical Center is a premier center for health care, biomedical research, and medical education. For over 167 years, NYU physicians and researchers have contributed to the practice and science of medicine. Today the Medical Center consists of NYU School of Medicine; Rusk Institute of Rehabilitation Medicine, the first and largest facility of its kind; NYU Hospital for Joint Diseases, a leader in musculoskeletal care; and such nationally recognized programs as the NYU Cancer Institute, the NYU Child Study Center, and the NYU Cardiac and Vascular Institute.