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Medical School Enrollment Grows, but What About Residencies?

By Jane Norman, CQ HealthBeat

October 23, 2012 -- The good news for medical schools is that aspiring doctors are applying at a robust pace. More than 45,000 U.S. students applied for the fall 2012 class; that included a record number of black and Hispanic students, and both minority groups achieved new highs in enrollment, according to a report released last week.

The bad news is that a funding cap on federally funded residencies that Congress imposed as part of the 1997 Budget Control Act (PL 105-33) remains, and leaders of medical colleges continue to warn that, without some action, a major problem looms by the end of the decade.

Darrell G. Kirch, president and CEO of the Association of American Medical Colleges (AAMC), said in a conference call with reporters Tuesday that an annual enrollment report prepared by the association shows improvements in the number and diversity of applicants for first-year medical training. “This is important because we are facing a physician shortage,” Kirch said.

The group has projected that the United States faces a shortage of 90,000 doctors by 2020, as older practitioners retire, the population grows and the health care law (PL 111-148, PL 111-152) expands access to health care.

In reaction, the AAMC has called for a 30 percent increase in enrollment, and Kirch said that’s being boosted by the addition of 11 new medical schools that began admitting classes between 2007 and 2012. Four more are slated to open by the fall of 2013, he said.

Medical schools are also doing more to recruit applicants from underrepresented backgrounds, he said, including through social media.

The report by the AAMC, a nonprofit association that represents all 141 accredited U.S. medical schools, said total applicants for the medical school class that entered in the fall of 2012 increased by 3.1 percent over the previous year. Overall, there were 45,266 applicants.

Kirch said many med school hopefuls had research experience already or had backgrounds in community service, showing that the “best and the brightest” continue to be attracted to careers in medicine.

Of the applicants, 3,824 were black, the largest number ever. There were 3,701 Hispanic applicants, again the largest number on record.

The report said 1,416 black students and 1,731 Hispanic students ultimately enrolled in medical school this fall. “The reality is the American population is becoming more diverse, and we need the physician population to reflect that,” said Kirch.

However, he warned that the class that entered this fall will be graduating in 2016 and seeking residencies, and unless Congress acts there won’t be enough slots available for all the aspiring doctors. Residences can take from three to seven years. “We just can’t ignore this problem,” Kirch said.

But, so far, the funding picture for residencies is not bright. Both parties have targeted graduate medical education, which Medicare supports, for cutbacks. A House measure (HR 6352) proposed by Illinois Republican Aaron Schock and Pennsylvania Democrat Allyson Y. Schwartz would add 15,000 graduate medical education slots over five years (See related story CQ Today, Aug. 6, 2012). In the Senate, Majority Leader Harry Reid of Nevada and fellow Democrats Bill Nelson of Florida and Charles E. Schumer of New York proposed a similar bill (S 1627). Both remain in committee.

Kirch said it’s difficult to get lawmakers to focus on the residency issue with the November election looming. “It’s a very uncertain time in Washington,” he said. But he said medical school leaders can’t think of a more important issue than ensuring that there are enough physicians at hand to serve the U.S. population in coming years. There are already shortages of surgeons in many areas and specialists such as child psychiatrists, he said. 

AAMC Enrollment Report (PDF)

Jane Norman can be reached at [email protected]

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