As I noted last week, I get a little annoyed by the seemingly constant public complaints of physicians, coupled with threats to leave medicine and dire warnings that no one will want to be a doctor in the future. This is in spite of it still being one of the most trusted professions around, and one that is darn well compensated. So it’s nice to see that the general public hasn’t bought into this meme yet (from the AAMC 2011 Medical School Enrollment Survey):
- First-year medical school enrollment in 2016–2017 is projected to reach 21,376. This projection represents a 29.6% increase above first-year enrollment in 2002–2003 and comes close to reaching the 30% targeted increase by 2015 the AAMC called for in 2006.
- Of the projected 2002–2016 growth, 58% will be at the 125 medical schools that were accredited as of 2002. New schools since 2002 will experience 25% of the growth, and the balance (17%) will come from schools that are currently in LCME applicant- or candidate-school standing.
- More than half (56%) of the 2002–2016 enrollment growth has already occurred, with 2,850 of the projected 4,888 new slots already in place as of 2011.
We’re facing a physician shortage, and in order to address this, the American Association of Medical Colleges recommended we increase the number of students training to be doctors. They’ve pretty much accomplished that goal. This is in spite of the bad press.
And get a load of this:
Applying to medical school is a grueling, time consuming process that, for many, does not end with acceptance letters. While business schools extended offers, on average, to nearly half of all applicants in 2010, and law schools admitted a rough average of 35 percent of prospects, medical schools accepted a much smaller portion of their applicant pools, according to an analysis of graduate school data reported to U.S. News.
In 2010, 521,876 applications were submitted to the 121 medical schools that reported entrance data to U.S. News. On average, just 8.9 percent of applicants were admitted—and at a handful of schools, the acceptance rates were drastically lower.
I look at numbers like that, and I thank my lucky stars I got in. I’m pretty sure the acceptance rate at my school was even lower.
Regardless of what some say, I don’t think we’ll have any trouble finding bright, dedicated people to become physicians in the near future.
Aaron E. Carroll, MD, MS is an associate professor of Pediatrics and the associate director of Children’s Health Services Research at Indiana University School of Medicine, as well as the director of the Center for Health Policy and Professionalism Research. Carroll’s work has been featured in The New York Times, USA Today, The Los Angeles Times, Newsweek, and many other national publications. He blogs at The Incidental Economist, where this post was originally published.
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They will regret it.
Thanks Aaron.
It’s true that some physicans are not happy with health care reform, and I would guess that some older doctors will retire early.
But younger doctors will replace them.
The problem is not that med schools lack applicants.
Insofar as we have a physician shortage in this country it is geographic: we
have more than enough doctors in some places (Miami and Manhattan come to mind) and not enough in others.
When med students graduate, few want to practice in poor rural areas or low-income inner cities.
The good news is that the Affordable Care Act provides scholarships for med students willing to “go where no one else will go.”
As I’m sure you know, the National Health Services Corp. was created in the 70s, and flourished for a while (IReaders: if you’ve evern seen the tv show “Northern Exposure,” the doctor on that show was part of the Corp.) Beginning in the 80s, gov’t funding began to fall off sharply. For more info, see http://www.healthbeatblog.com/2011/03/primary-care-and-the-national-health-service-corps-finding-physicians-who-will-go-where-no-one-else-.html
But the ACA has helped give it a new lease on life. The $1.5 billion that the Accountable Care Act set aside for the Corps marks a final win for Ted Kennedy.
Students who sign up for the Corps are often coming from low-income who actually want to practice poor rural areas–or low-income inner cities–because that is where they grew up. They understand the needs of the patients in those communities, and want to “give back”. Sixty percent stay put even after they have served in these communities the number of years required by their scholarships.
Students who grew up in households earning less than $25,000 or $30,000 a year (max) are not as likely to be unhappy with physicians’ pay, even in primary care.
This is not to suggest that primary care docs who care for low-income patients should be paid far less than other physicians.
The other piece of good news is that the ACA raises Medicare fees for primary care, lifts Medicaid fees for primary care to Medicare levels, and provides bonuses for primary care docs who create “medical homes,”
while providing additional funding for community health centers where many will work.
Considering the post was about the number of people who want to be doctors, I think the number of applicants is far more relevant than the number of applications each applicant submits or the acceptance rates of schools. If each applicant applies to 15 schools next year and the number rises to 645,000, would you say the number of applicants is up?
If you look at the chart in the link I cited in my first comment, you will see that the number of applicants has been rather stable over the last several years.
If you define 43,000 people as “lots and lots,” then so be it. Don’t forget that many of those who don’t get into an AAMC school, go to med school offshore.
At worst you can accuse the author of an ambiguous statistic, but your response muddies things further.
For example, your 44% acceptance statistic and the 8.9% statistic are about different things, but you present it as a disagreement. 44% of people who apply to at least one medical school are accepted to at least one med school. On average each person applies to 11 schools. Someone rejected from 10 schools and accepted at one counts in your number. But for each school, the acceptance rate is much lower than 44%…it is about 8.9% as the author states. Both numbers are relevant, neither is wrong.
The ACA created some residency slots focused on primary care. It also included a process for redistributing unused slots that should add to the resident pool.
The AAMC pretty much controls the number of Med School slots available, whereas residency slots are mostly funded by CMS. When the AAMC decided on the goal of increasing med school slots by 30% they were able to achieve this remarkably fast. Plans for new medical schools and expansions have gone full-steam ahead even as educational dollars have waned. I have not heard of schools facing a shortage of qualified applicants either. So the will is there.
As I understand it, over the next few years more US medical school graduates will be applying to roughly the same number of residency slots. This will make it harder for the foreign graduates to find a US residency, but will not result in significantly more physicians per capita.
I don’t have any data to back it up, but it seems likely that productivity is dropping among physicians, for several reasons including more part time physicians and more employed physicians. I do know that in my state more than 1/2 of physicians are over 50. Many that I know have had to put off retirement due to the changes in the economy (especially due to the loss of equity in their home and their office building) but when (if) the economy, and specifically real estate recovers, there may be an up tick in retirements. Whether or not there is a shortage of physicians, it does not seem likely to change in the near to mid term and may get a little worse.
What do y’all think about this?
“Approximately 15 percent of all healthcare workers and 25 percent of all physicians in the United States were born and educated elsewhere. This means that 1.5 million healthcare jobs are “insourced,” occupied by foreign-born, foreign-trained workers brought into the United States on special visas earmarked for healthcare jobs. This number is 50 percent greater than the total number of jobs in the U.S. auto-manufacturing industry. It’s amazing to consider that in 2008 and 2009, the auto industry, which makes up just 3.6 percent of the U.S. economy, received a $97 billion bailout. If we estimate that each of these 1.5 million insourced healthcare jobs has an average wage of $60,000, that’s $90 billion a year in wages going to people brought into the United States to work rather than training Americans to do the same jobs.
The healthcare industry makes up 16 percent of our economy. Yet even in these days of close to 10 percent unemployment, we do not invest enough money in our young people to train them for jobs in healthcare — an already understaffed industry that will have to serve an additional 32 million people once the provisions of the 2010 health-reform law take full effect. Instead, when faced with pressure from hospitals and nursing homes for more healthcare workers, the federal government grants visas to import nurses, physicians, pharmacists, physical therapists, and many other types of healthcare workers from countries that can ill afford to lose them…”
http://www.salon.com/writer/kate_tulenko/
521,000 applications were submitted to 121 medical schools. Did it occur to you that applicants might have applied to multiple schools. According to the AAMC, there were 43,919 applicants (not applications) to med school in 2011-12.
Over the last 20 years, the number of applicants has a biphasic distribution with the highest number, 46,965, occurring in 1996-97. Here’s a link to the AAMC website’s chart of these data. http://is.gd/usBvxa
521,876 divided by 43,919 = 11 applications per applicant. And 19,230 applicants matriculated. 19230/43919 = 44% of those who applied to medical school were admitted, not 8.9% as you claim.