Stalled Progress: Medical School Dean Demographics.

Medical schools have an important directive: to train the next generation of physicians. Faced with a primary care physician shortage, increasing numbers of under-represented faculty leaving academic medicine, low representation of women in leadership positions, and an ongoing pandemic, medical schools have a duty to implement solutions to alleviate these issues. Efforts have been made to create more diverse medical school classes, but those efforts are not mirrored in senior faculty demographics. In this medical students' perspective piece, the authors analyzed the demographics of medical school deans in comparison with the United States' demographics and the current composition of active physicians. The authors looked at the specialty, race/ethnicity, and gender of medical school deans in 2019. Based on the analysis, in 2019 only 11% of deans were under-represented minorities, 16% of deans were primary care physicians, and 18% of deans were women. When compared with the makeup of physicians in the United States and the population as a whole, these numbers are unrepresentative of national demographics. By hiring deans with a variety of race/ethnicities, specialties, and genders, schools set an important precedent that could lead to more pipeline programs, increased under-represented faculty retention, and more primary care physicians.

Medicare Support for Dental and Podiatry Graduate Medical Education Programs.

Importance: Oral health care faces ongoing workforce challenges that affect patient access and outcomes. While the Medicare program provides an estimated $14.6 billion annually in graduate medical education (GME) payments to teaching hospitals, including explicit support for dental and podiatry programs, little is known about the level or distribution of this public investment in the oral health and podiatry workforce. Objective: To examine Medicare GME payments to teaching hospitals for dental and podiatry residents from 1998 to 2018, as well as the distribution of federal support among states, territories, and the District of Columbia. Design, Setting, and Participants: This cross-sectional study was conducted using data from 1252 US teaching hospitals. Data were analyzed from May through August 2020. Exposures: Dental and podiatry residency training. Main Outcomes and Measures: Medicare dental and podiatry GME payments were examined. Results: Among 1252 teaching hospitals, Medicare provided nearly $730 million in dental and podiatry GME payments in 2018. From 1998 to 2018, the number of residents supported more than doubled, increasing from 2340 residents to 4856 residents, for a 2.1-fold increase, while Medicare payments for dental and podiatry GME increased from $279 950 531 to $729 277 090, for a 2.6-fold increase. In 2018, an estimated 3504 of 4856 supported positions (72.2%) were dental. Medicare GME payments varied widely among states, territories, and the District of Columbia, with per capita payments by state, territory, and district population ranging from $0.05 in Puerto Rico to $14.24 in New York, while 6 states received no support for dental or podiatry residency programs. Conclusions and Relevance: These findings suggest that dental and podiatry GME represents a substantial public investment, and deliberate policy decisions are needed to target this nearly $730 million and growing investment to address the nation's priority oral and podiatry health needs.