Once medical students have completed medical school and received their MD degrees, what is the next step? Would they be able to immediately start their own practice and see patients?
“Contrary to some beliefs, you can't graduate from medical school and go out into practice. You actually have to complete some postgraduate or graduate medical education training,” says Dr. Kate Martin, associate dean for graduate medical education (GME) at the Kirk Kerkorian School of Medicine at UNLV.
The duration of postgraduate training can range from three to seven years, depending if someone decides to pursue fellowship training after their residency. During residency, individuals are able to spend more time learning and training in their chosen specialty, while also preparing to become fully licensed physicians. Fellowship training, which comes after residency training, allows physicians to become sub-specialists in their field.
Residency and fellowship programs play a pivotal role in retaining physicians in the state: 55.2 percent of physicians who have completed GME in Nevada, and 76.9 percent of physicians who have completed both undergraduate medical education (UME) and GME in Nevada have stayed to practice in the state, according to the Physician’s Workforce in Nevada: A Chartbook - 2022 Edition published by University of Nevada, Reno’s (UNR) Nevada Health Workforce Research Center.
This is why the Kirk Kerkorian School of Medicine’s leadership is working heavily with the University of Nevada, Reno School of Medicine to further increase GME programs, with both schools meeting with Nevada state legislators to emphasize the importance of GME to the state.
“I think that the draw of GME, to help make the case or demonstrate the value, is that these aren't just training programs,” Dr. Martin says. “These are physicians who are going to be able to see patients from day one in collaboration with their attending physicians. These programs bring people with expertise that we may not currently have in the community.”
Currently, the Kirk Kerkorian School of Medicine is a sponsoring institution of 11 residency specialty programs and 11 fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) – with additional fellowships accredited by specialty societies. The office of GME constantly works to develop and establish new residency and fellowship programs, but there is a lot that goes into the creation of these programs.
The process for establishing a new residency or fellowship program can take a minimum of two years, but the average is three to four years. There are various things to consider, such as the educational sites for the residents and fellows; the funding for the program; establishing program leadership; and identifying “what resources currently exist in the community, what resources you need to bring to the community, and then how to put that all together.”
Martin emphasizes the importance of “making connections” in the community “because it's not something we can just create on our own.”
“It requires a collaborative effort, whether it's hospital partners, clinical sites, and also just different educational opportunities … there's a lot of collaboration in the process [for] building a program that's sustainable from a funding standpoint,” Martin says.
Despite the long process, Martin believes GME is “a worthwhile investment.”
“It creates educational opportunities for our students, but it also translates directly to patient care and healthcare for people living here,” Martin says. “... I don't know anything else that can instantly make that dramatic of an impact for students, for the learners, and for the patients.”
