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University of Minnesota- St. Cloud Family Medicine Residency. Joe Blonski, MD Program Director. Program Outcomes. 15 Total Residency slots- 12 Funded and 3 unfunded Total Graduates (Program started in 1996) 63 Practicing in Minnesota 76% Practicing in towns < 20,000 41%
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University of Minnesota- St. Cloud Family Medicine Residency Joe Blonski, MD Program Director
Program Outcomes • 15 Total Residency slots- 12 Funded and 3 unfunded • Total Graduates (Program started in 1996) 63 • Practicing in Minnesota 76% • Practicing in towns < 20,000 41% • Practicing in St. Cloud 29% • Practicing Obstetrics 52% • ABFM Board Pass Rate- First attempt 95%
Family Medicine Trends • Nationally- 25% increase in FM positions filled over the past five years- currently around 3000 annually • Increased percentage of FM positions filled thru the match over the past 10 years- 96% compared to a low of 79% • % of FM positions filled by US Seniors- has remained constant at around 45% over past five years but down from over 70% in the mid-1990’s • St. Cloud- 1150 annual applicants for 5 slots; larger percentage of local U of M student applicants over past two years • Minnesota: • One of the healthiest states in the country with a 1258:1 population to primary care ratio (better than the mid-west and national averages) • Higher percentage of FM physicians comprising the state primary care workforce than most other states • Will require 1200 additional primary care physicians by 2030 to meet the current needs
Opportunities and Challenges • Funding • Nationally- recent IOM recommendations on GME financing • State- Governor’s Task Force • Locally- Hospitals feeling the squeeze- challenged to support GME • Changing Rural Practice Models • Differences between Baby Boomers, GenX, Millennials in work-life balance • Hospitalists • ER coverage • Team based care • Change in Family Medicine Models • Full spectrum • Outpatient only • Hospitalists • Rural ER • Locums • Training Challenges • High acuity, low volume procedures (C-sections, Endoscopy, Chest tubes, etc.) • Simulation center • Rural Fellowships
Residency Funding • Medicare IME/DME • MERC/PMAP • Rural Health Grant • Currently used to pay for resident salaries • Potential Future uses: • Simulations Center costs • Fellowship training • Expansion of residency training positions
Recommendations to the Commission • Dedicated funding to bolster primary care training • Medical school debt relief for those entering and remaining in the Minnesota primary care work force- special focus on rural • Find ways to support hospitals that host primary care residency training- special focus on rural • Support Primary Care at the Federal Level • Expand residency positions in first-certificate programs • 50% of new GME positions in Primary Care • 50% of Primary Care positions in Family Medicine • Set thresholds for sponsoring institutions and hospitals to establish and maintain primary care positions • Fund a National Health Care Workforce Commission