U.S. medical school enrollments have increased 31% since 2002, according to 2018 medical school enrollment survey results, a new report from the AAMC. Combined with first year enrollment in osteopathic schools, the number of medical students is now 52% higher than in 2002-03.
Responding to concerns that a predicted physician shortage could impact patient care, the AAMC in 2006 called on medical schools to increase first-year enrollments by 30%. This target was achieved in 2018-2019, when first-year enrollment reached 21,622 students. Schools of osteopathy increased their enrollment by 164% during this same period, with 8,124 first-year students enrolled.
âFrom a supply side, what we really need to focus on right now is the residential slots. The federal government must begin to cover its fair share of the costs again. It starts with lifting the caps.
Atul Grover, MD, Ph.D.
AAMC Executive Vice President
âFrom a supply side, what we really need to focus on now are the residency niches,â said Atul Grover, MD, PhD, executive vice president of AAMC. âWe have been doing everything we can on the medical school front to reduce the physician shortage, and I think the numbers bear this out. The federal government must begin to cover its fair share of the costs again. It starts with lifting the caps.
Residence training positions have grown at a rate of only 1% per year, largely due to a Congressional cap on federal funding in the Balanced Budget Act of 1997. Most of the costs Residence training – about $ 171,855 per year, per resident on average, according to AAMC data – is supported by teaching hospitals and their faculty. Medicare (US Department of Health and Human Services) has historically paid for 21% of the training. However, this support has been largely frozen since 1997. A domestic bill introduced in March – the Resident Physician Shortage Reduction Act of 2019 (HR 1763) – would add up to 15,000 Medicare-funded residency positions over five years. , similar to an AHA- supported invoice presented in April to the Senate.
Concerns about residences
The AAMC administered the 15th annual medical school enrollment plan survey in November 2018 to deans of 151 accredited U.S. medical schools. In the survey, 44% of deans expressed concern about their students’ ability to find residences. Sixty-eight percent of Deans expressed concern about available residency spaces in their states, and 75% were concerned about residences nationwide.
A shortage of resident positions ultimately has a big impact on the physician shortage, Grover says. âIn the long term, we are concerned about the slow growth in resident positions as we need more doctors,â he says. “This is the biggest problem.”
A 2019 study conducted for the AAMC by IHS Markit predicts that the United States will face a shortage of 46,900 to 121,900 physicians by 2032.
“I am really, really proud of what our medical schools have done to increase enrollment and at the same time have looked for ways to make care more efficient,” said Karen Fisher, JD, public policy manager. of the AAMC. âBut we need more niche for higher medical education (CME) because we need more doctors. We simply do not have enough to be able to produce the number of physicians to meet the predicted shortage.
Day school competition
The lack of places of residence is not the only concern raised by the survey. Deans are also concerned about the shortage of clinical training sites for internships and rotations. As the number of students in the health professions increases to meet the health care needs of a growing and aging population, schools are finding it increasingly difficult to find high quality educational sites. in their communities.
According to the survey, 85% of respondents were concerned about the number of training sites, while 88% were concerned about the supply of qualified preceptors.
âAs our medical schools have grown, they need more educational opportunities for students,â says Grover. âEveryone is competing for the same day school sites. It’s definitely something we hear about more and more all the time.
The survey found that 46% of those surveyed felt moderate to severe pressure to pay for training slots. However, 53% of schools do not. The three specialties that are experiencing the greatest shortages of training places are obstetrics and gynecology at 55%, pediatrics at 52% and family medicine at 47%.
While concerns about the availability of residences and clinical training sites are increasing, schools are trying to offset some of the negative effects.
On the residency front, there are a few options, according to John Prescott, MD, academic director of AAMC.
The ideal solution, he says, includes increased federal funding for physician training as well as increased efficiency of care. Teaching hospitals are actively pursuing new models of team-based care and greater use of technology, and are supporting nearly 15,000 residency positions above their âcapâ without any federal support. They are also working with hospitals that have never been teaching hospitals to establish new residency training programs, he says.
âWe know there are benefits to having learners in our practice plans and our hospitals,â Prescott says. âIf you are a family doctor and have residents and students working with you in the clinic, you are constantly being asked for ways to treat patients more effectively. Residents force us all to learn and improve continuously.
âWe know there are benefits to having learners in our practice plans and our hospitals. Residents force us all to learn and improve continuously.
John Prescott, MD
Academic Director of AAMC
The lack of clinical training sites for third and fourth year students, however, continues to be a challenge. âWithin our academic health centers, we can often make sure that we have faculty and patients to maintain the highest educational standards,â Prescott said. âHowever, we also want to ensure high quality experiences throughout the community – in outpatient clinics, homes and other settings. Finding and supporting volunteer clinic teachers can be a daunting task.
Prescott says it would help schools make multi-year agreements with clinical training sites rather than doing it year by year.
âThey’re looking for a longer term commitment,â Prescott says. âLong-term agreements provide some necessary stability for medical schools and medical educators. And we believe that learners continue to improve the quality of care provided throughout our community. Membership in a medical school is a sign of excellence.