In a world where six figures of medical student-loan debt are the norm, the path toward becoming a physician in a primary care specialty might feel daunting. That was the case for Jessica Fanelli, MD.
“I come from a middle-class family,” Dr. Fanelli said. “My mom's a nurse, my dad's a mechanic, so they definitely couldn't pay for my medical school, and I worked all through undergrad to pay for my schooling.”
The Abigail Geisinger Scholars Program, offered by the Geisinger Commonwealth School of Medicine, gave Dr. Fanelli the opportunity she needed. The program offers students full tuition and a monthly living stipend in exchange for a commitment to work in the Geisinger health system after their training.
“Having medical school covered and not having [to worry] about paying for it has been wonderful,” said Dr. Fanelli. She is now a first-year family medicine resident at Danville, Pennsylvania-based Geisinger, which is part of the AMA Health System Member Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
“Medical school has gotten ridiculously expensive and not having that financial burden is really great in terms of opening up specialty choice,” Dr. Fanelli said.
How it works
Inclusive of tuition and stipends, the estimated value of the Abigail Geisinger Scholars Program for medical students exceeds $300,000.
Students accepted into the medical school can choose to apply to the Abigail Geisinger Scholars Program. After a secondary review process, selected students begin medical training with full financial support and structured academic and career development tailored to primary care or psychiatry.
In turn, medical students in the program commit to working as Geisinger physicians after completing their residency, with one year of service repaying the equivalent of one year’s tuition support, and a minimum required service commitment of two years. That means that to get four years of medical school funded, the students must commit to work at Geisinger for four years.
By comparison, programs such as the Public Service Loan Forgiveness Program require 10 years of service to achieve debt elimination. Dr. Fanelli found the service requirement to be a benefit.
“I'm from Northeastern Pennsylvania,” she said. “I plan to stay here and Geisinger's a huge employer in the area. So, training in a system and then being employed with that same system will allow me to hit the ground running in terms of knowing the resources and the specialists and the patients.”
Meeting workforce needs
Julie Byerley, MD, MPH, is president of Geisinger College of Health Sciences and dean of Geisinger Commonwealth School of Medicine. She said the Abigail Geisinger Scholars Program is part of a workforce strategy tied directly to serving rural communities in Northeastern and Central Pennsylvania.
“While there's a physician shortage everywhere, there is a significant shortage in rural communities— especially in the needed disciplines of primary care and psychiatry,” said Dr. Byerley, an AMA member.
The program launched in 2019 and has grown significantly since. Thus far, it has shown strong results. Two scholars are currently practicing Gesinger physicians; 107 alumni are in residency or fellowship, and more than 150 medical students are now in training as Abigail Geisinger Scholars.
“Within the next decade or so, you’ll see a transformation of a physician presence in our footprint that’s going to really make a difference to the people we serve,” Dr. Byerley said.
“I am extremely grateful to Gesinger Health System for the significant investment they have made in this program that really aligns with our academic and clinical missions,” she added.
Dr. Byerley’s efforts to reshape the physician workforce included working on a project through the AMA’s the AMA Reimagining Residency grant program. The project— entitled Developing Residents as Systems Citizens: The Systems-Based Practice Competency for the 21st Century Healthcare System—aimed to train residents to be better equipped to contribute to the evolving systems of care and the construction of clinical learning environments that foster such development.
Strength in continuity
The curricular model at the heart of the program offers unparalleled continuity for trainees, and that is reflected on both sides of the training equation.
“When people are thinking about, ‘This person is going to work alongside me,’ it makes everyone invest more of their attention, heart and soul into training our learners,” Dr. Byerley said.
Dr. Fanelli touted the mentorship and a targeted curriculum that equips scholars with valuable institutional knowledge as aspects of the program that are hard to replicate for students who will go elsewhere for residency.
“We go through a series of seminars dedicated for people going into primary care and psychiatry, and that really helped me learn resources that are available in primary care and within the Geisinger system,” she said.
“We have value-based care guides that we learn about as medical students. We learn billing and coding towards the end of our fourth year, and that's not something that a lot of other programs offer.”
Investing in medical students
In looking at the scalability of a program for other areas looking to grow their primary care workforce, Dr. Byerley is bullish on investing in future physicians.
“Many health systems invest a lot in trying to recruit physicians,” she said. “Investing early in medical students is the transformative idea.”
The investment will pay off in ways that extend beyond health outcomes. Dr. Byerley hopes that medical students and residents who train in the communities Geisinger serves will stay local, as Dr. Fanelli plans to.
“Medical education takes a long time, so for many students this training pathway—with four years of service after residency—will span much of their 20s and early 30s,” Dr. Byerley said. “Our hope is that, during this time, they'll grow roots in our community and invest in it in other ways.”
The financial impact this program offers to medical students cannot be understated. But Dr. Byerley believes it also puts future physicians on a path toward career fulfillment.
“How you feel in your heart is most important to your job satisfaction,” she said. “Realizing that you can use your skills and talents to make a positive impact and serve your community leads to a meaningful career. This sense of purpose will help you stay motivated and resilient through the challenges of medical school and your future career.”
