Primary care physicians are increasingly essential, yet alarmingly scarce globally. This shortage significantly impacts healthcare systems, as these doctors are the cornerstone of preventive medicine and the vital link connecting patients to specialized care and essential health services. Recognizing this critical need, the Keck School of Medicine of USC has proactively developed the Primary Care Initiative (PCI), featuring the Primary Care Program, designed to inspire and equip more medical students to choose careers in primary care.
Launched in 2011 by the Department of Family Medicine, the Primary Care Program at USC is a specialized pathway for a diverse group of medical students. It focuses on immersive, community-based primary care experiences, primarily serving underserved urban populations throughout their medical education. A recent study evaluating the program’s effectiveness through an alumni survey reveals compelling evidence of its success. This type of survey, rare in its scope, assesses not only postgraduate training fields but also the long-term career paths of practicing physicians. Remarkably, 71% of the 86 program respondents successfully matched into primary care residencies, encompassing family medicine, internal medicine, pediatrics, and medicine-pediatrics. Furthermore, for those who had completed or were nearing completion of their residency, a significant 70% were actively practicing primary care or firmly on track to do so.
“Medical schools often lack sufficient primary care physician role models,” explains Dr. Jo Marie Reilly, MD, MPH, the founding director of PCI and a professor of family medicine at the Keck School of Medicine, and the study’s senior author. “Our program provides a crucial platform for students to witness the vast scope and profound impact of primary care services, allowing them to truly envision their own rewarding careers in this field.”
The findings of this study were published in Family Medicine, a leading peer-reviewed journal, co-authored by Dr. Isabel Edge, MD, assistant director of PCI and a clinical assistant professor of family medicine, and Ilana Greenberg, MPH, PCI manager.
Addressing the Critical Shortage of Primary Care Physicians
The data underscores a significant success: 40% of USC Primary Care Program alumni who entered internal medicine residencies chose to practice or intended to practice primary care. This figure starkly contrasts with national averages, where only 10% to 15% of internal medicine residents pursue primary care, with the majority opting for hospitalist positions or subspecialties like oncology or cardiology.
“Our comprehensive training at the Keck School of Medicine appears to strongly reinforce students’ dedication to primary care,” Dr. Reilly notes. “The program’s immersive nature, with students actively engaged in community settings, is key. We consistently hear from our alumni that the continuity of patient care and the deep, lasting relationships they build with patients are incredibly meaningful. For many, this is the very reason they were drawn to medicine in the first place.”
Reflecting the Primary Care Program’s community-focused mission, an impressive 90% of alumni practicing medicine are serving urban communities. Moreover, 77% reported accepting Medicaid or Medi-Cal, indicating their commitment to serving underserved patient populations.
Beyond direct patient care, program alumni are also deeply engaged in other crucial areas. Sixty percent serve as mentors for current medical students and postgraduate trainees, 62% are involved in teaching, 31% hold medical leadership positions, and 24% participate in healthcare advocacy.
“We emphasize that effective care extends beyond the clinic walls,” Dr. Edge states. “We actively foster mentorship, leadership, and advocacy within the program because these are intrinsically linked to the essence of primary care.”
Building a Robust Model for Future Primary Care Training
Dr. Edge highlights the strong sense of community fostered by the Primary Care Program. Medical students entering the Keck School of Medicine with a passion for primary care find a supportive network of peers, dedicated faculty mentors within family medicine, and experienced physician preceptors who provide invaluable real-world experience in their practices.
“There’s immense value in nurturing and sustaining the initial passion students bring with them,” she explains. “We aim to strengthen their commitment to primary care throughout medical school, so they graduate even more dedicated to serving in this vital field. The program’s strong community aspect is instrumental in achieving this.”
A primary motivation for rigorously documenting the Primary Care Program’s outcomes is to provide a proven, effective model and curriculum that other medical schools can adopt. For PCI leaders, wider dissemination of their successful approach is crucial to significantly expand their impact on the primary care physician shortage.
“Students arrive with a strong sense of idealism about their future medical practice,” Dr. Reilly concludes. “Our program effectively demonstrates the integrated, comprehensive, and holistic patient care that is not only possible but essential in primary care. Our curriculum is specifically designed to keep their passions ignited. Looking ahead, we believe the Primary Care Program serves as a successful training model, and we are actively sharing our work and insights with colleagues nationwide.”
Dr. Edge adds, “We recognize that we cannot solve the primary care shortage single-handedly. Our hope is that by providing robust evidence of our program’s effectiveness, we can inspire and empower colleagues at other institutions to enhance their own programs and collectively train the next generation of primary care physicians.”
