Title VII and the Development and Promotion of National Initiatives in Training Primary Care Clinicians in the United States

Davis, Ardis K. MSW; Reynolds, P Preston MD, PhD; Kahn, Norman B. Jr MD; Sherwood, Roger A. CAE; Pascoe, John M. MD, MPH; Goroll, Allan H. MD; Wilson, Modena E.H. MD; DeWitt, Thomas G. MD; Rich, Eugene C. MD

doi: 10.1097/ACM.0b013e31818906c9
Title VII Section 747: Primary Care Medicine and Dentistry

The Title VII, Section 747 (Title VII) legislation, which authorizes the Training in Primary Care Medicine and Dentistry grant program, provides statutory authority to the Health Resources and Services Administration (HRSA) to award contracts and cooperative agreements aimed at enhancing the quality of primary care training in the United States.

More than 35 contracts and cooperative agreements have been issued by HRSA with Title VII federal funds, most often to national organizations promoting the training of physician assistants and medical students and representing the primary care disciplines of family medicine, general internal medicine, and general pediatrics. These activities have influenced generalist medicine through three mechanisms: (1) building collaboration among the primary care disciplines and between primary care and specialty medicine, (2) strengthening primary care generally through national initiatives designed to develop and implement new models of primary care training, and (3) enhancing the quality of primary care training in specific disease areas determined to be of national importance.

The most significant outcomes of the Title VII contracts awarded to national primary care organizations are increased collaboration and enhanced innovation in ambulatory training for students, residents, and faculty. Overall, generalist competencies and education in new content areas have been the distinguishing features of these initiatives. This effort has enhanced not only generalist training but also the general medical education of all students, including future specialists, because so much of the generalist competency agenda is germane to the general medical education mission.

This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

Ms. Davis is teaching associate, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington, and an independent consultant, AKD Consulting, Mukilteo, Washington.

Dr. Reynolds is professor of medicine, Division of General Internal Medicine, Geriatrics and Palliative Care, Center for Biomedical Ethics and Humanities, University of Virginia, Charlottesville, Virginia.

Dr. Kahn is executive vice president and CEO, Council of Medical Specialty Societies, Chicago, Illinois. At the time of the projects described herein, Dr. Kahn was vice president for science and education, American Academy of Family Physicians, Leawood, Kansas.

Mr. Sherwood, now retired, was, at the time of the projects described herein, executive director, Society of Teachers of Family Medicine, Leawood, Kansas.

Dr. Pascoe is professor of pediatrics, Department of Pediatrics, Boonshoft School of Medicine, Wright State University, Detroit, Michigan.

Dr. Goroll is professor of medicine, Harvard Medical School, Boston, Massachusetts.

Dr. Wilson is senior vice president of professional standards, American Medical Association, Chicago, Illinois.

Dr. DeWitt is associate chair for education and professor and director, General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Dr. Rich is Tenet Healthcare Endowed Professor, Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Ms. Davis, AKD Consulting, 9438 56th Ave. W., Mukilteo, WA 98275; telephone: (425) 423-0922; fax: (425) 423-8673; e-mail: (ardisd7283@aol.com).

© 2008 Association of American Medical Colleges