Refining a method of identifying CUNY Medical School graduates practicing in underserved areas.

PURPOSE: To determine what percentage of graduates from the City University of New York (CUNY) Medical School/Sophie Davis School of Biomedical Education practiced in underserved areas of New York State and, in the process, to develop a reliable way of collecting and verifying the information needed to carry out such an outcomes study. METHOD: The study group consisted of the 414 CUNY graduates who had completed their MD degrees by 1986. Addresses of graduates' practices were confirmed for 79% of the graduates, 49% of whom practiced in New York State. New York State zip codes were used as a way to identify underserved areas throughout the state. RESULTS: Of the 160 graduates with practices in New York State, 33% had practices in underserved areas (and 81% of these were located in New York City). In all, 26% of the whites, 73% of the African Americans, 43% of the Asian Americans, 50% of the Latinos, 34% of the women, and 32% of the men had practices in underserved areas. CONCLUSION: The graduates' race-ethnicity was an important factor in the likelihood of their practicing in an underserved area, whereas gender was not, a finding consistent with previous studies. Medical schools and residency programs need to institute long-term programs to track the career paths of all their graduates so that questions about the proportions of graduates in underserved areas will be relatively easy to answer.

The Sophie Davis School of Biomedical Education: the first 20 years of a unique BS-MD program.

BACKGROUND: Since 1973 the Sophie Davis School of Biomedical Education, City University of New York Medical School, has integrated baccalaureate education with preclinical medical education; its graduates earn BS degrees in five years and are then eligible for entry into the traditional third year of medical school at one of seven participating medical schools in New York State. The school has a twofold mission: (1) to expand access to medical careers among inner-city youths, particularly among underrepresented minorities, and (2) to encourage the pursuit of primary care specialties among its graduates. METHOD: To assess the extent to which the two goals of the school have been met, the authors collected and analyzed information on the 1,402 students who entered Sophie Davis between 1973 and 1992, especially the 1,068 students from the 15 classes that entered the school from 1973-74 through 1987-88. In particular, the analysis focused on data on academic achievement and on choice of practice specialty. Where possible, state and national data were used for comparison. RESULTS: The results suggest that the school has achieved varying degrees of success: (1) The program has expanded access to medical careers among underrepresented-minority students at success rates well above national averages for college freshmen entering traditional premedical curricula. (2) Graduates have chosen primary care specialties at a somewhat higher rate than the national average, despite the school's lack of official involvement with students once they began clinical training in medical school. CONCLUSION: The aggregate data show that the school has achieved success in expanding access to medical careers for inner-city youth (especially among underrepresented minorities) and has been at least partially successful in nurturing primary care physicians. The latter goal may be realized more fully if the school becomes more involved in the clinical education of its graduates.