Integration of student-health physicians into U.S. medical schools and their affiliated teaching hospitals.
To determine whether physicians in the student health services (SHSs) at U.S. medical schools and their affiliated teaching hospitals, referred to here as academic medical centers (AMCs), have unique opportunities for integration into AMCs that do not exist for physician-faculty at SHSs on purely academic campuses. A survey of SHS offices at the 124 U.S. medical schools was conducted in the spring of 1999. The questionnaire asked about the reporting relationships of the SHS within the AMC, whether the student-health physicians had academic appointments within the AMC, and whether these physicians participated in the AMC's clinical services, administration, research, or teaching activities. There were 116 (94%) responses (not all responses were complete and eight were excluded because their campuses offered no formal SHS). Approximately half of the SHSs (52/107, 49%) reported to their AMCs. Student-health physicians with career-track appointments were more likely to be found at SHSs reporting to AMCs (35/58, 60%) than at SHSs reporting solely to a division of student affairs (20/58, 34%). Having a career-track appointment increased the likelihood of the student-health physicians' attending on the wards (34/59, 58%), seeing private patients in an AMC's faculty practice (40/59, 68%), participating in administrative activities for an AMC (50/56, 89%), and participating in research activities (36/57, 63%). Student health services that reported to their AMCs were more likely to have faculty with career-track appointments, and these appointments were more likely to result in the integration of student-health physicians into their AMC's clinical services, administration, and research activities. Career-track appointments, however, had no influence on whether teaching activities occurred within the SHS. Fully integrating student-health physicians into the AMC's activities enhances outcomes for both the SHS and its AMC.