What is the problem that needs to be addressed? Please describe how it is related to mental health.
Psychiatry Medical Residency Programs consistently attract the lowest or next to lowest performing medical students as measured by USMLE Step 1 and USMLE Step 2 CK scores (National Residency Matching Program Charting the Match Annual Report). NRMP data also shows that Medical Students entering Psychiatry have some of the lowest participation rates in Abstracts, Presentations, and Publications.
Mental Health and Psychiatric Organizations are late in attracting future healthcare providers to an interest in Mental Health/Psychiatry. While other medical specialties/organizations utilize Clinical Care Extender and Volunteer Programs, Psychiatry typically does not. The first time for such an opportunity in Psychiatry is the MS-3 year when medical students do a required rotation in Psychiatry. Until the MS-3 year, medical students do not have much interaction with Psychiatric Patients, unlike most other medical specialties.
The informal interactions between practicing physicians, allied health professionals, future physicians in medical school, premedical students and high school students help form future career interests and business opportunities. Psychiatry has some of the largest opportunities for discovery, but does not adequately attract the human resources required to find those discoveries. The difference in age between a high school and MS-3 Medical Student is at least 7 years.
Why is this a concern for Orange County? What can Orange County and other counties learn from this project?
Currently, the only route to Board Certification in Psychiatry is through a Psychiatry Residency Program listed in the National Resident Matching Program (NRMP). NRMP data shows that the pool of future Psychiatrists has some of the lowest key performance indicators compared to other medical specialties. There is also a spillover effect. The cohort of young people that volunteer don’t necessarily enter the industry, career or medical specialty where they initially invest their time. Experiences are carried over to future opportunities and can provide a base of common knowledge for future collaboration.
What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?
What is being done? Unknown. Is it Working? NRMP Charting the Match Annual reports over the last decade suggest whatever strategy is being used hasn’t impacted NRMP key performance indicators.
What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.
Historically, Psychiatry operates on the fringe of medicine, law and society. Mental health has a history of locked wards, security issues, and a different standard of rights for patients. Introduction of volunteers or the “non-initiated” to a mental health setting has risks of disruption to healthcare operations and shock to the volunteer. Orange County – possibly other jurisdictions -has previously made investments that enable a volunteer or Clinical Care Extender program in Psychiatry/Behavioral Health.
What is the project idea? Please describe how this project will operate.
Orange County has invested in Wellness Centers and other facilities that are unlocked and do not have the security risks historically experienced in mental health. These facilities can initiate Volunteer & Clinical Care Extender Programs.
- Examples of Clinical Care Extender/Volunteer Programs include:
- Hoag (https://www.hoag.org/about-hoag/volunteer/health-scholar-program-pre-med-nursing-program-/)
- St. Jude (https://www.stjudemedicalcenter.org/st-jude-memorial-foundation/volunteer/)
- VITAS Medicare Requirement for Hospice Volunteers (https://www.vitas.com/resources/volunteers/hospice-volunteers-and-medicare-law)