Today’s NY Times hosts an article discussing the future of expansion in the U.S. medical education system. Proponents of the increase state that with the competitiveness of medical school applications and rejections leave bright students fleeing to offshore medical schools, or leave them giving up hope entirely. Their solution is to create more supply for the demand.
While I can’t disagree with the solution, the article fails to discuss a more important component that will limit the number of U.S. physicians; the number of residency positions.
When a medical student finishes medical school, they are a doctor that cannot practice medicine. That medical student has to be trained for an additional 3-7 years in a sub-specialty residency position. Currently there are ~15,000 medical school positions and an equivalent number of residency positions in the U.S.. More plainly, an increase in medical schools will make residency even more competitive with no actual increase in the annual production of practicing physicians.
The article goes on about expanding care with nurse practicioners (NP) and physicians assistants (PA) and while these providers are a useful tool, they are not a replacement for doctors and should not be treated as such.
Following this article, I suspect increased pressure will be put on the AMA and other policy makers to address the real rate limiter in medical education and expand residency training positions so that rural America will finally see an increase in the number of practicing doctors. Until then, they are only putting a band aid on a much larger problem- and making real money on each entering students tuition.
By Keyana Azari
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