Introduction

The Physician Reentry into the Workforce Project is a multi-organization, collaborative effort that aims to address the wide range of issues related to physician departure and subsequent reentry into the workforce, specifically clinical practice. This is being accomplished through a number of venues including the development of these Issue Briefs. This issue brief proposes a plan and provides a diagram for a reentry education program for physicians.

Despite the significant number of physicians who leave practice for an extended period of time and then seek to return, there is no formal or centralized system for physicians to reenter the workforce. Most physicians draw upon relationships with other physician colleagues in order to reenter, and very few do any sort of retraining to ensure clinical competence. The few existing formal reentry programs can be expensive and may present geographical barriers for some physicians. These programs also vary in their curricular content and format and the types of physicians they accept for training. As public attention increasingly focuses on demonstration of clinical competence, concerns about consistent quality standards for both individual physicians and reentry programs may require consideration, and some states are indeed setting licensure requirements for inactive physicians. A formal reentry system might, therefore, be effective in addressing concerns about the quality of reentry programs and reentering physicians.

Schema for a Reentry Educational System: a Two-Pronged Approach

In the following figure, two theoretical pathways for reentry are proposed. The first, labeled “Planned Disengagement,” describes a reentry pathway to meet the needs of physicians who are planning to leave the workforce with the intention of returning. This pathway serves as a prospective approach to reentry, focusing on the Resources these physicians will need during their period of inactivity to prepare them to return. Resources include guidance on how to maintain state licensure and board certification, an individualized learning plan for continuing medical education during disengagement, and mentoring and networking opportunities to prevent professional isolation of inactive physicians. The second pathway, “Reentry After Unplanned Disengagement,” depicts a pathway for physicians who did not do any preparatory work before exiting the workforce. This pathway provides a set of basic Resources for these physicians at the moment they are seeking to reenter practice. These Resources include educational materials, such as specialty-specific and other relevant literature, in-training exams, and self-assessments; mentoring; potential practice assessment or simulation; and guidance on potential reentry programs and other training opportunities.

It is hoped that these two pathways would ultimately serve to inform the development of a formal reentry educational system. In such a system, reentry programs and others would cooperate to formulate assessment and evaluation instruments and measures, curricular content and standards, follow-up mechanisms, and a classification of reentering physicians. This would promote some standardization and

consistency across programs, where appropriate. Efforts to ensure optimal education would be supported through an infrastructure of faculty development, mentoring, financial and institutional support, and workforce planning. Finally, a database of reentry programs would allow the system to track important data on the demographics of reentry system participants, the content of programs, and the outcomes of both reentering physicians and reentry programs, allowing for the system to be self-reflective and responsive through continuous quality improvement initiatives. At some point, this formal reentry system would interface with regulatory bodies that govern licensure, specialty certification, credentialing and other professional standards and privileges.

Resources

The Web site at www.physicianreentry.org provides additional information on the Physician Reentry into the Workforce Project. The Web site also contains practical Resources for both physicians seeking to reenter the workforce and others interested in the issue, including employers, educators, regulatory groups, and medical and specialty societies.

Fair Use Policy: Individuals or organizations interested in distributing this Issue Brief or using its content should acknowledge the authorship of the Physician Reentry into the Workforce Project in an appropriate citation.

Suggested Citation: Physician Reentry into the Workforce Project. Issue Brief: Schema for a Reentry Educational System. Elk Grove Village, Ill. American Academy of Pediatrics; 2009.

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RESOURCES

The Web site at www.physicianreentry.org provides additional information on the Physician Reentry into the Workforce Project. The Web site also contains practical resources for both physicians seeking to reenter the workforce and others interested in the issue, including employers, educators, regulatory groups, and medical and specialty societies.

Fair Use Policy: Individuals or organizations interested in distributing this Issue Brief or using its content should acknowledge the authorship of the Physician Reentry into the Workforce Project in an appropriate citation.

Suggested Citation: Physician Reentry into the Workforce Project. Issue Brief: Schema for a Reentry Educational System. Elk Grove Village, Ill. American Academy of Pediatrics; 2009.