Articles: primary-care.
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Many medical schools have implemented primary care tracks to increase the number of medical students pursuing primary care. The Primary Care Program (PCP) at the Keck School of Medicine of University of Southern California is a 4-year primary care pathway that trains medical students to work in urban, underserved communities and has shown high student match rates into primary care residencies. This study evaluates the PCP graduates in residency and after residency, and assesses their career outcomes, their career characteristics, and the impact their PCP experience had on their careers. ⋯ PCP alumni credit this program with impacting their retention in primary care and their career trajectories. This program can serve as a model for other institutions to help increase the number of medical students who pursue primary care careers.
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Background Prostate-Specific Antigen (PSA) is used in primary care for prostate cancer detection, either for symptomatic assessment or asymptomatic testing following an informed decision. Aim To estimate the proportion of prostate cancer cases diagnosed following asymptomatic PSA testing, and patient and practice factors influencing this route. Design and setting 2018 English National Cancer Diagnosis Audit (NCDA) data were analysed, with linkage to the national cancer registry, practice-level Quality Outcomes Framework (QOF), and General Practice Patient Survey (GPPS) data. ⋯ Younger age, non-White ethnicity, lower deprivation, and lower co-morbidity count were associated with an increased likelihood of diagnosis following asymptomatic PSA testing. There was a 13-fold variation between practices in the odds of asymptomatic PSA-detected cases, without clear explanatory GP practice-level factors. Conclusion One in five patients with prostate cancer in England are diagnosed after asymptomatic PSA testing in primary care, with large variation in asymptomatic PSA detection between GP practices.