• December 20, 2014

Medical-School Applications Barely Rise Even as Doctor Shortage Looms

Despite the opening of four new medical schools and the expansion of at least a dozen others, applications to American medical schools inched up just 0.1 percent this year, according to data released today by the Association of American Medical Colleges.

Medical schools reached a little deeper into their applicant pools to increase first-year enrollments by 2 percent this year, to about 18,400 students. But the increase will make limited headway toward staving off what the association worries will be a shortage of 124,000 to 159,000 physicians by 2025. Fueling fears of a shortage are an aging population, an expected wave of retirements of baby-boomer physicians, and the possibility that millions of people will join the ranks of the insured if health-care-reform legislation is enacted.

"U.S. medical schools are stepping up to keep the pipeline of new physicians flowing so all Americans will have access to the care they need regardless of whatever form health-care reform takes," the medical association's president, Darrell G. Kirch, said during a news conference today.

Half of the enrollment increase was at the four new medical schools that accepted their first classes this year, at Florida International University, Texas Tech University, the University of Central Florida, and the Commonwealth Medical College, an independent institution. A fifth new school will open next year, at Virginia Tech, with at least three more schools in the pipeline.

In addition, 12 existing medical schools expanded their 2009 class sizes by at least 7 percent this year.

Preventing a Bottleneck in the Pipeline

Getting more students into medical school is one struggle. Creating enough positions for them to continue their supervised training after graduation remains another.

"We must also increase the number of residency training slots to prevent a bottleneck in the pipeline of new physicians, and ensure access to care for the millions of Americans who hopefully will attain coverage under health-care reform," Dr. Kirch said.

The association supports legislation that would increase the number of Medicare-supported training positions by 15 percent, or about 15,000 slots. The number of Medicare-financed slots is frozen at 1996 levels.

But the legislation's price tag—approximately $12-billion over 10 years—may have scared off lawmakers, who are simultaneously trying to cut health-care costs.

None of the health-reform bills under consideration by Congress would increase Medicare spending for graduate medical education. They would instead redistribute about 1,000 unfilled residency training slots among a small group of states.

In this year's applicant pool, men outnumbered women, 52 percent to 48 percent. The number of black applicants increased by 4 percent this year, while the number of Hispanic applicants dropped by 1 percent.

Dr. Kirch said he was optimistic that applications would be up next year. From January to August of this year, more than 67,000 people took the Medical College Admission Test—nearly 3 percent more than the same period last year.

Similar efforts to expand the physician pipeline are taking place at the nation's osteopathic medical schools, whose graduates are more likely to pursue careers in primary care.

Comments

1. 12077884 - October 20, 2009 at 03:57 pm

As a disclaimer, I work at a physician assistant program. I don't feel that a shortage of physicians should necessarily mean a shortage of medical care. Medical schools are the highest cost method of increasing health care access and availability. Increased funding for physician assistant programs and nurse practitioner programs are much lower in cost and result in more of the graduates staying in the area of the school. Medical school students seldom stay where they go to schools while residency programs only keep about one-half of their studens in the area. There are many gaps where PAs and NPs can fill the void, especially in primary care, at a much lower cost and without a drop in quality. Admit it, those of you who go to a PA really love her or him.
DK

2. amiller - October 20, 2009 at 04:24 pm

Amen, concur with DK. It appears that the applicant pool for PA education is expanding and not contracting.
AAM

3. dennydenise - October 21, 2009 at 09:50 am

As the parent of a recently minted doctor, I think that medical schools, and perhaps the federal government, need to help students with the high cost of medical training. My daughter has well over $100,000 in medical school loans and is a resident making about $40 K. Many indiviuals are opting for other types of careers without the high debt and more lucrative employment outcomes upon degree completion! My daughter enjoys her work and career choice very much but is overwelemd with her level of debt.

4. davi2665 - October 21, 2009 at 10:45 am

It is understandable that many college graduates do not see a rosy future in becoming a physician. The total debt load from their education is staggering. The expectations for endless paperwork, bureaucratic regulation, and reimbursement issues are nightmarish. Most physicians are working longer hours and receiving less reimbursement than in past years; many primary care physicians are lucky if they earn the same hourly wage as a plumber or an electrician. Both the federal and state governments see endless Medicare and Medicaid cuts in reimbursement as a good stop gap measure to prevent them from dealing with their out-of-control budgets and falling revenue from a spiraling economic disaster. At least half of physicians currently would not recommend the profession to their children. Physicians often have to get "permission" from some perfunctory bureaucrat without any medical training in order to carry out a procedure deemed necessary for their patient's well being. And then they are second guessed by regulatory retreads; and if anything goes wrong, they will, of course, have the bevy of vulturous lawyers on their backs, seeking to cash in on adverse outcomes. Torte reform? Not in this century. And for those currently dissatisfied, it is likely to get much worse, with governmental control of decisions on which treatments can be used, what diagnostic procedures are "permitted", and what massive spreadsheets of metrics and endless data must be recorded (of course, with onerous penalties if a mistake is made in the data gathering, or one of the myriads of codes is improperly recorded). Many students are justifiably concerned about a profession with a highly uncertain future, in which they are likely to be forced, for economic survival, to take a salaried position working for one of the remaining hospitals that will be fortunate enough to survive the endless reimbursement cuts and never ending federal mandates and interference. One of my students who has chosen a career in engineering and nanotechnology summed it up well- "Medicine? Are you kidding? Yah- sign me right up!"

While PA training certainly is an option for those wanting to provide supervised medical care, they still need to work in conjunction with physicians, on whom the challenges above mainly fall.

5. tridaddy - October 21, 2009 at 02:13 pm

While recently having a conversation with an MD acquaintance in town, he said he would not recommend that a young person go to medical school but choose nursing or one of the allied health specialities. The options and opportunities are greater, the cost is less and the ROI is greater considering time in traiing to actually practicing, working hours, etc.

6. udoekaiko47 - October 21, 2009 at 04:13 pm

PAs and NPs are quite capable of providing primary care services. They should be freed from physicians to provide healthcare without supervision. The AMA can help out by encouraging medical schools to provide three year general/family practice programs for those who want to become MDs. Board certified NPs and PAs should be encouraged to do one extra year of advanced medical training if physicians really believe that these great clinicians need more training.

7. aacom - October 21, 2009 at 04:57 pm

This article barey mentions osteopathic medical education, one of the fastest-growing sectors in U.S. medical education. Osteopathic medical schools now account for one-sixth of the nation's accredited medical schools.

2009 applications to osteopathic medical colleges hit record levels for the third year in a row. More than 12,600 potential medical students applied for this year's 4,933 osteopathic medical college seats, an increase of 7.5 percent over 2008. The total osteopathic medical college applicant pool has been increasing for seven years, and applications for the 2010 entering class are on track to continue this trend. To date, 2010 applications again are up by 7.5 percent over this time last year.

First-time enrollment at the nation's 25 colleges of osteopathic medicine jumped to nearly 5,000 this year, a 7.3 percent increase over fall 2008. Today, more than 17,000 students, or nearly one in five of all U.S. medical students, are studying at osteopathic medical schools.

The education osteopathic medical (DO) students receive is rigorous and thorough. Like their allopathic (MD) counterparts, incoming DO students are required to have strong undergraduate science backgrounds, have excellent Medical College Admission Test (MCAT) scores, and meet stringent admissions criteria. Also like their allopathic counterparts, osteopathic medical students participate in years of classroom, clinical, internship, and residency training. And when they leave that training, they become board-certified physicians, licensed to practice the full scope of medicine in every state in the country.

8. docdonny - December 10, 2009 at 10:18 am

I think you need to distinguish between primary care medicine and specialist medicine. Primary care is yes not lucrative but being a specialist is another story. Your student who chose nanotechnology over his friend who is going to medical school to enter a speciality will see that in a few years his MD friend will be making more than double what he makes. Its not that students aren't going in medicine, its that they are not going into primary care and thats what the article is talking about. A distinction need to be made.

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