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The 1999 Minnesota Legislature asked for a study of the borrowing and repayment problems of students in the Academic Health Center (AHC) at the University of Minnesota. Findings of this study show that most graduate and professional students at the AHC borrowed by the time they completed their graduation or professional programs. Many borrowed $50,000 or more and will use more than 10% of their incomes to repay their loans in the early years after graduation. Most undergraduates borrowed, but the average amount was $13,300, and a borrower with a $30,000 income will use 5% of annual income to repay this amount in student loans (assuming 7% interest and a 10-year repayment plan). Average borrowing amounts and estimated income percentages requires for repayment are given for students in these departments of the AHC: (1) dentistry; (2) medicine; (3) nursing; (4) pharmacy; (5) public health; (6) and veterinary medicine. Findings suggest that all graduate and professional students at the AHC would benefit from additional debt counseling, and employers may want to consider loan repayment assistance as an employee benefit. Appendix 1 describes the terms and conditions of the loan program, and appendix 2 describes loan repayment programs for professionals who work in designated health professional shortage areas. (SLD)

This paper describes RaPiD, a computer-aided assistant for the design of dental prostheses called removable partial dentures. The user manipulates icons directly to indicate the desired design solution to a given clinical situation. A developing design is represented as a logic database of components in a design; expert rules are applied as integrity constraints governing valid database transactions/design alterations. RaPiD has two modes of operation: manual mode designed for educational use (at either "student" or "expert" level), and automatic, which is intended for dentists in practice. In automatic mode, the dentist enters key clinical information, after which the system takes over and completes the design. Contravention of design rules is presented to the user in a critiquing style. The critiquing style strategies form the basis for the system's use in undergraduate and graduate dental education. Critiquing strategies used include: (1) a critique is issued only when the user has completed the proposed alteration; (2) a critique is issued immediately upon the user's radical misuse of a tool; (3) critiquing dynamically without negotiation with the user; (4) critiquing requested by the user upon completion of a design session, or at certain other stages in the design process; and (5) optional critiquing, requested by the user who wishes to compare his design with that which would have been produced independently by the system. An assessment of the educational effectiveness is planned. Expanding the range of design rules in RaPiD so that it becomes comprehensive is a current priority, as is the introduction of critiquing strategies (4) and (5), as well as completion of the automatic mode of operation. The extensive use and testing of RaPID, already carried out, show it to be a versatile and robust knowledge-based system. (Contains 14 references.) (Author/MAS)

This document provides selected information on characteristics of health personnel disciplines, students preparing for these disciplines, their schools, projections of the personnel supply in each discipline to the year 2020, and discussions of whether the U.S. requirements for health personnel are likely to be met. Following an introduction, chapter 2 provides an overview of major personnel developments, including trends in education and training, the current supply of health care personnel, issues affecting health personnel, and health personnel in the coming years. Current and emerging health issues and personnel issues are covered in chapters 3 and 4. Among the health issues covered are an aging population, infant mortality, human immune deficiency virus, acquired immunodeficiency syndrome, substance abuse, access to health care, a changing health delivery system, and quality assurance and effectiveness in medical practice. The personnel issues addressed include declining applicants and enrollments, the shortage of nurses, primary health care concerns, concerns regarding allied health and public health labor supply, personnel for health care in geriatrics, and underrepresented minorities in the health professions. Chapter 5 discusses the data and methodology used to produce this report. The next 11 chapters provide information on physicians, dental personnel, nursing personnel, public health personnel, allied health personnel, optometrists, pharmacists, podiatrists, veterinarians, chiropractors, and physician assistants. The document contains reference lists that follow each chapter, 95 tables, and 75 figures. (CML)

This report highlights trends in disease patterns and technological advances that call for sweeping changes in the education of oral health personnel. It first provides a brief history of the development of dental education. The second and most extensive section analyzes global trends for dental caries, periodontal conditions, tooth loss and edentulousness, developmental disorders, systemic diseases, and traumatic injuries. The third section considers what these trends will mean in terms of the demand for different categories of oral health personnel and for low-, moderate-, and high-technology care. The report notes that the clinical functions required of oral health personnel will change from the simple to the complex. The second half of the report discusses the immediate educational changes needed to protect against an oversupply of oral health personnel, overqualified for routine clinical functions yet inadequately trained to perform necessary specialized, sophisticated procedures. Topics include advantages of a health sciences approach organized on modular lines, changes in curricula that can support revised educational objectives, and methods for setting and maintaining educational standards. Fifteen specific tasks that can contribute to effective changes in educational systems for training dentists and auxiliary personnel are outlined. Eleven references are listed. Appended is a statement of the general aim and objectives for a first course for oral health professionals. (YLB)

Second in a series, this report presents recent trends in the supply and characteristics of health professionals, developments in health professions education, and projected requirements for health professions personnel are reported. In addition to data on the supply of health personnel and population growth, information is provided on the activities of health professionals, kinds of practice they pursue, and their practice settings. Attention is also directed to the role of foreign medical graduates in health care and the potential reduction in their role under present legislation, and the representation of women and minorities in the health professions. Additional topics include: accessibility to professional services, geographic distribution of health professionals, increasing specialization among health care practitioners, and health professions personnel shortage areas. Developments in health professions education are covered, including: enrollment patterns, trends in student characteristics, the establishment of new schools and programs, and students' financing of their education. In addition, efforts of the Bureau of Health Manpower and the National Center for Health Statistics to provide information and comprehensive data on health personnel are addressed. Finally, estimated requirements for physicians and other health personnel are presented. (SW)

While the dental education expansion in Illinois has been notable, some problems remain to be addressed in the last half decade of the 1970's. There is a geographic maldistribution of dentists, with more dentists per capita in the urban areas, particularly Chicago, than in the downstate rural areas. While some progress has been made, considerable growth of ethnic minority enrollments must occur before such students are proportionately represented in the state's dental schools. The expansion of dental education in Illinois undertaken in 1968 will result in substantially more dentists. The increase should maintain and will likely improve Illinois' position among the top 15 states in terms of dentists per capita. In recognition of the substantial increases made to date and some of the dental care problems in Illinois, the following recommendations build upon the progress made to date: The three Chicago-area dental schools should meet their current enrollment projections. The necessary state funds for completing the expansion of dental education in the public dental schools should be provided through the usual budget review and appropriation processes. The private dental schools should be awarded an annual operating grant of $3,000 per Illinois resident student. Affirmative action efforts in each dental school should be continued and expanded. Each school should attempt to enroll and retain a student mix that ethnically and geographically reflects the population base from which it draws its Illinois students. (Included are statistics on supply of dentists, enrollment, and graduates.) (JT)

This document provides descriptive profiles of the current and past supply of health manpower and projections of manpower supply to 1990. It presents detailed descriptions of the methodology and techniques used to derive the profiles and projections, and provides interpretations and evaluations of the adequacy and comparability of existing statistics, with descriptions of the more conspicuous gaps in the current health manpower information system. The health manpower occupations covered are the major health professional categories, including a number of specialities within these categories, and selected groups of allied health professions and occupations. The report was developed to provide a wide range of users of health manpower statistics with a comprehensive reference compendium of basic information on major health occupations. It was prepared in 1972 and 1973 as part of a major manpower study within the Bureau of Health Resources Development. The chapters are divided into two main parts. The first part provides an overview of the concepts, methodology, and assumptions underlying the estimates and projections. It also presents summary highlights of the study in both tabular and narrative form. The second part presents detailed statistical material on the current manpower profile and projected supply in specific health fields. These two parts are followed by appendixes that include detailed projection tables presenting information not shown separately in individual chapters. (Author/KE)

Highlights of the findings from a three phase study are presented in the report. Data were drawn from annual surveys, beginning in 1966, of the entire entering freshman classes at a national sample of higher education institutions and from followup studies, at subsequent intervals, of smaller subsamples of the same students. The growing popularity of the health fields of study, gains and losses in specific fields, and the impact of changing enrollment patterns are described. Health career aspirants are compared to nonhealth aspirants, and trends in the characteristics of health aspirants over a six-year period are identified. Patterns associated with stability in, recruitment to, and defection from a major in the health fields are focused on in reference to health majors. A final section profiles aspirants to specific health careers (physicians, dentists, nurses, laboratory technicians, and therapists) with emphasis on those who planned to become physicians. The report concludes that such factors as demographic attributes, socioeconomic backgrounds, academic ability, self-image, values, and institutional characteristics play an influential role in student choices of probable major, actual major, career, and specialty within a career. Appended are selected statistical tables (24 tables) for each of the study's three phases. (Author/MS)

The report describes and evaluates the concept and implementation of an interdisciplinary School of Health Professions (SHP) as well as its key educational features and financial requirements. SHP focuses on primary health care, interprofessional education and care-delivery, and self-paced curricula. Six types of health professions comprise the initial student body: primary-care physicians, primary-care dentists, nurse practitioners, clinical pharmacists, graduate social workers, and health care coordinators. The University of the Pacific's program prepares students to deliver the specific kinds of primary-care services required in professional practice. The following aspects of the SHP are discussed: (1) roles and responsibilities, selection, and orientation of faculty; (2) criteria and procedures for student selection; (3) SHP organization and governance; (4) systematic procedures for evaluating students, curriculum, faculty, administrators, and the organizational structure; (5) a communications system for the flow of information among the people involved in SHP; (6) steps for developing a full curriculum; (7) the support and participation of health professionals during the feasibility study; (8) requirements for accreditation and licensure in California; (9) the stages in the implementation of SHP; (10) financial projections; and (11) remaining tasks. A list of sites visited and a bibliography are included. (Author/EC)

This report details concerns of specific Asian and Pacific American Communities and examines the degree to which government agencies at federal state, and local levels have made efforts to resolve these problems, or, in some cases, contribute to them. The study deals with educational opportunities afforded Chinese American youth; housing and redevelopment problems faced by Japanese Americans; allegations of inadequate social services allocated to Pacific Americans; the various problems faced by the elderly within the Pilipino communities; and the difficulties encountered by Korean and Philippine-educated professionals in obtaining state licensure. State licensure policies are examined in four health fields as they affect the large number of Koreans and Philippines born and educated professionals residing in California. The difficulties encountered by these subgroups in resuming their professions are said to present significant socioeconomic problems within the Asian and Pacific communitiesin that they lack adequate health care and medical services and are deprived of the services of trained medical personnel with whom they could communicate effectively. Among the recommendations made are that the state licensure boards review their standards to see that qualified professionals are not screened out, and that they endorse and actively support training programs for foreign-educated in the medically-related professions. (Author/AM)

To provide a general picture of how the private dental office personnel picture is expected to evolve under particular assumptions, this report presents the projections of the national supply and requirements for dentists for 1980, 1985, and 1990. General implications for dental auxiliary personnel are also discussed. Factors determining the demand and supply of dental services, which include past demand, population growth, economic growth, dental insurance coverage, and technological progress, are analyzed along with developing trends in dentistry and their anticipated effects on supply and demand. Areas identified for needed additional research include dental prepayment and fluoridation. A fifty-six-page appendix describes in detail the supply-demand forecast model used and examines past and developing trends which affect dental supply and demand relationships: engineering advances, organizational change in dentistry, prevention of dental disease, and third-party payment. (BL)

The document presents a Department of Health, Education and Welfare (HEW) special report on dental care for the handicapped. The nature and extent of the problem of providing dental services to the handicapped population is examined. The handicapped population is defined and their oral health status reviewed. Factors contributing to the poor oral health of the handicapped are considered. Current HEW programs impacting on dental care for handicapped people are described, including those in the Health Care Financing Administration, Office of Education, Office of Human Development Services, and Public Health Service. Nine areas needing strengthening or improvement are discussed, including the coordination of federal activities related to the oral health of the handicapped and the training of dental students and practicing dentists in the care of handicapped persons. Fourteen suggested actions for the department are offered, including the establishment of a focal point within the department for activities relating to the oral health of handicapped people, and changes in the Medicaid law and/or regulation. (DLS)

The need for health personnel in California and recommended targets for expansion of health sciences programs are presented in this report prepared for the California PostsecondarV Education Commission. The report focuses on the role of physicians, mid-level practitioners, nurses, pharmacists, dentists, optometrists, and health sciences education. Supply trends and projections, demand, utilization, clinical training, and special problems, and recommendations are considered for each field. Pertinent national legislation is assessed and it is suggested that the true impact of this legislation will not be felt on the state level for at least a decade. The effect of professional liability insurance rate increases on patterns of physician practice are also presented for the State as well as the impact of national health insurance on health manpower. Health sciences education programs are discussed focusing on the needs of the health care delivery system that are amenable to change via the educational system, and needs of the educational system itself. System changes that are recommended in the education field include improved practitioner attitudes toward primary care, and prevention of disease through patient and health education. Data for health services professionals including: geographic distribution, field, and speciality are appended as well as a list of accredited health professions schools in California and degrees conferred. An explanation of the basic project methodology is also included. (SF)

Egalitarian attitudes and the personality traits of instrumentality (masculinity) and expressiveness (femininity) were examined for 314 male and 71 female dental students and for women in dental auxiliary programs. The objectives were to (1) investigate their possible correlates (e.g., parental occupation, status, age) and to compare the attitudes toward societal roles of women held by professional and paraprofessional groups with the attitudes of the general population and (2) examine dental students' self-reports of masculine/feminine attributes. The Attitude Toward Women Scale (AWS) and the Personal Attributes Questionnaire (PAQ) were administered to three classes of dental students, female dental hygiene students, and women in the dental assisting program at the University of Minnesota. Among the conclusions are the following: (1) Women who enter dentistry are different from college women in general--stronger on the instrumentality trait and weaker on the expressiveness trait--and also hold more egalitarian attitudes towards women's roles. Except for their attitudes towards women's roles, these women are much more similar to dental men than to other women. (2) Professional men are only slightly different from college men on the masculinity trait, with slightly though significantly higher scores and slightly more egalitarian attitudes toward the roles of women. (3) A comparison between dental students and a group of established professionals seems to suggest that women entering dentistry do so because they are like the men of dentistry. Questions for research as well as for professional education in U.S. dental schools are posed on desirable gender-associated personality attributes for the dental health practitioner, and the effect of these characteristics on patient treatment styles, public access to dental care, and the individual's oral health condition. (CC)

Dental school enrollments and the supply and demand of dentists in the United States and the south are examined. The growth in the supply of dentists in the South is related to an improved economy in this region and a rapid population increase. In addition to producing a large number of dental school graduates, the South is attracting graduates of schools outside the South. A reduced demand for dental services is linked to improved oral hygiene, the wide use of flourides, and the fact that dental care is often deferred because dental expenses usually are paid by the consumer. Between 1980 and 1984, first-year dental school enrollments declined 16.3 percent in the United States and 20.3 percent in the South. The number of applicants has decreased from 14,807 in 1975-1976 to 6,200 for 1985-1986. In 1976, dental schools accepted only 40 percent of applicants, while 77 percent were accepted in 1984. Reasons for declining application rates include: rapid increases in dental school costs; high debt among dental school graduates; and reduced earning potential in dentistry. Since dental school enrollments are likely to continue to decline, options that might be helpful to states with public dental schools are identified. Data on 1980-1984 first-year and total dental school enrollments in 14 southern states and the United States are included, along with data on cost-per-student. (SW)

Descriptions of the number and distributions of minority physicians, dentists, and pharmacists within certain geographically and demographically defined areas are provided. Data from the Bureau of the Census for the 1980 Decennial Census were used in examining distribution patterns of minority and non-minority practitioners by geographic region, number of inhabitants, poverty status of the area, and primary care manpower shortage area designation status. Where possible, practitioner-to-population ratios by race/ethnicity are also presented for localities. This study's findings indicate: (1) Asians outnumbered other minority groups, especially within the physician supply; (2) uneven distribution patterns occurred among geographic regions of the country regardless of race/ethnicity; (3) all racial/ethnic professionals were disproportionally located in heavily populated areas, but minority health professionals were more likely than white health professionals to reside in the most populous counties; and (4) an overwhelming majority of all health professionals resided in counties which were not classified as high poverty areas. Numerous tables are contained throughout the text and in the appendix. (ML)

A study was conducted to describe the family patterns and attitudes toward dentistry of women dentists. The data for this study were collected through a questionnaire distributed to 226 women dentists selected from the 1979 membership list of the American Association of Women Dentists, with a return of 65 percent. Almost half of those surveyed had been out of dental school only 1-10 years, while approximately one-fifth had been out 30 or more years. Frequency and percentage tallies were compiled and chi-square correlations were used to compare subgroups of the sample. Analysis of the data showed that 86 percent of the women have been or are now married, while 14 percent never married. Of those who did marry, 45 percent married for the first time during the first 10 years after dental school graduation, while 49 percent married for the first time either before or during dental school. One in six has been divorced or separated. Approximately half of those who married have either one or two children, while 34 percent have no children. Sixty-nine percent of those who had children had their first child during the first 10 years after dental school graduation. Although dental school produced a strain on marriages, most marriages were happier after graduation. Conflicts between home and work were acknowledged by one-fifth of the women. Most of the women were involved in private, rather than group, practice of general dentistry. The study concluded that career satisfaction among the women dentists was very high. Approximately 90 percent of the respondents indicated they find dentistry financially rewarding; they enjoy the opportunity to be independent and to interact with their patients; and they do not find dentistry repetitious or boring. Three-fourths of the group would choose dentistry again and would encourage a daughter to do likewise. (KC)

Designed to provide assistance in the assessment of the need for biomedical and behavioral research personnel, this report presents research findings related to specific medical careers. The review includes an examination of the system under which biomedical and behavioral scientists are trained for research careers and the United States government programs that support them. An introductory chapter provides an overview of the assessment procedures, findings, and recommendations. Specific study results are discussed for: (1) the clinical sciences (identifying trends in medical and dental schools); (2) basic biomedical sciences (including a survey of biotechnology firms and a market outlook for biomedical Ph.D.s); (3) behavioral sciences (explaining current supply/demand indicators); (4) health services research (providing definitions and examples of current health services research and identifying funding sources for this area); and (5) nursing research (examining doctoral programs and trends in nursing). A bibliography contains references from individual authors and also agency reports. Data from the assessment are provided in six appendices. (ML)

Information is presented on the number and characteristics of health professionals in the United States, students preparing to enter these fields, and the schools in which they are enrolled. Developments and issues currently affecting these health personnel and the possible impact of these trends on health care delivery are considered. Included is information on accreditation, curricula, enrollments, applicant and student characteristics, student costs and financial aid, graduates, women and minority physicians, medical costs and cost containment, geographic distribution of physicians, allopathic medical education, and osteopathic medical education. Information is included on data collection and analytical activities that are currently ongoing and the areas in which further information or analyses are needed. Recommendations about program activities for nursing and public health are included. The following personnel are covered: physicians, physician assistants, dentists, pharmacists, optometrists, podiatrists, veterinarians, nursing personnel, public health personnel, and allied health personnel (including clinical laboratory technicians, dieticians, medical records technicians, occupational therapists, physical therapists, radiologic technicians, respiratory therapists, and speech, language, and hearing therapists). Summaries, data tables, and reference lists follow each of the 10 chapters dealing with a separate occupational category. (SW)

A University of North Carolina study using focus groups of dentists and patients found dentist-patient interactions play an important role in treatment decision-making, and are predicated on non-clinical factors, including dentists' intuition and judgment and patient impressions of dentists' examination styles, personalities, and interpersonal ability. Implications for dental education focus on interplay of clinical and psychosocial factors. (MSE)

Shay, Simpson, and Biernat describe geriatric dentistry training that included mentorship and shared experiences with physician trainees. Cohen and Lyles describe a fellowship program in which physicians care for older patients in unique settings and conduct research projects. (SK)