More medical students than ever, but more residency slots needed to solve physician shortage, AAMC says

Male doctor in white lab coat
There's been an increase in the number of medical school students, but residency slots haven't kept pace, an Association of American Medical Colleges survey found. (Getty/Saklakova)

There’s more medical school students than ever before, but there’s still a big obstacle to solving a predicted physician shortage.

While U.S. medical school enrollment has increased, averting a physician shortage now depends on more residency training slots, according to the results of an annual survey from the Association of American Medical Colleges (AAMC).

The number of residency positions has increased only 1% a year, far lower than the 52% growth in medical school spots since 2002, the AAMC said. Federally supported residency training slots have been capped by Congress for more than 20 years, limiting the spots for medical school graduates to undergo additional training in a residency program before they can practice medicine.

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Earlier this year, the AAMC estimated a shortage of up to 122,000 physicians by 2032 including up to 55,000 in primary care and 66,000 in other specialties.

The AAMC called for a 30% increase in medical school enrollment in 2006 in response to concerns about a future physician shortage. The good news? Medical school enrollment surpassed that goal in the most recent academic year.

But it took longer than desired. The AAMC hoped for the 30% increase by the 2015-2016 academic year, but it took until 2018-2019.

Enrollment in U.S. medical schools grew by 31% since 2002. Combined with increases in enrollment at schools of osteopathic medicine, overall medical school enrollment is now 52% higher than it was 17 years ago, the AAMC reported.

The expansion is a result of increases in class sizes at existing medical schools and the creation of new medical schools. Since 2002, 29 new accredited medical schools have opened, along with 17 new schools of osteopathic medicine, the AAMC said.

“U.S. medical schools have responded to the AAMC’s call to action by significantly expanding enrollment,” Atul Grover, M.D., AAMC’s executive vice president, said in a statement. “Now the national focus must shift to increasing the number of residency training slots so the nation will have enough physicians to combat the impending shortage and care for our growing and aging population.”

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As of the 2018-2019 academic year, first-year enrollment at U.S. medical schools had increased to 21,622 students, and first-year enrollment at schools of osteopathic medicine was 8,124 students, according to the new report "Results of the 2018 Medical School Enrollment Survey."

The survey was sent to the deans of 151 accredited U.S. medical schools and received a 91% response rate.

The survey found that medical school deans are worried about the lack of residency slots: 75% expressed concern about the availability of residency slots nationally, and 44% expressed concerns about their own incoming students’ ability to find residency positions of their choice after medical school. Over half of schools reported they experienced difficulty in finding clinical training sites for obstetrics/ gynecology and pediatrics.

Additionally, 85% of deans expressed concern about the availability of clinical training sites, and a majority reported experiencing competition for sites from other healthcare professional training programs, a substantial increase from about 25% of respondents who reported concerns in 2009.

To increase the supply of doctors in the U.S., the AAMC supports a multipronged approach, including passage of legislation by Congress that would provide a modest but critical increase in the number of federally supported graduate medical education positions.

A bill, the Resident Physician Shortage Reduction Act of 2019, is awaiting action in both the Senate and the House of Representatives. It would gradually provide 15,000 Medicare-supported residency positions over a five-year period starting in 2021.

“The cap on residency positions will continue to exacerbate the projected physician shortage until Congress acts,” Grover said. “The medical education community has done its part. Now, Congress must do its part by passing the bipartisan Resident Physician Shortage Reduction Act.”

The government is looking at other ways to address the physician shortage. Just this week, it was announced that 27 healthcare organizations across the country will receive federal money to set up new residency programs to train more doctors to work in rural areas. The organizations, located in 21 states, will be awarded approximately $20 million in grants, with funding through the Health Resources and Services Administration.

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