The number
of people applying to law schools is in steep decline. So says a recent post
on a website called “The National Jurist.”
The post
cited some remarkable statistics from the American Bar Association. In 2012, law
school applicant numbers were down 14% from 2011 and 23% from 2010.
For the
fall of 2012, there were 44,481 first-year law students enrolled, a drop of
about 4,000 from 2010.
Many
schools have decreased enrollments with more than 90 cutting class sizes by
more than 10%.
On January
2, 2013, the Wall
Street Journal said, “The Bureau of Labor Statistics estimates that
the economy will provide 21,880 new jobs for lawyers annually between 2010 and
2020; law schools since 2010, however, have produced more than 44,000 graduates
each year.”
For the
non-math majors, that’s a ratio of more than two graduates for every job.
There
are way too many lawyers around anyway.
Could
something like this happen in medicine? It might not be exactly the same, but an
interesting dilemma is looming. A 2011 paper in the New
England Journal of Medicine expressed concern that in a couple of years, the
number of US medical school graduates will exceed the number of first-year
residency training positions available.
In
response to projected physician shortages, many medical schools have expanded
their class sizes, and several new medical schools have opened or are soon to
open.
But the
problem is that many years ago, the federal government established a cap on the
number of residency training positions in this country. And there are
persistent rumors that spending on graduate medical education (GME) will be
among the many future budget cuts. It is also not a “given” that existing
residency programs could be expanded or more programs could be established even
if funding became available.
Here
is what Dr. Thomas Nasca, CEO of the Accreditation Council for Graduate Medical Education,
had to say in that NEJM article. “We estimate that … domestic production of
medical school graduates [will] functionally surpass our current total number of GME
postgraduate year-one pipeline positions (posts that lead to initial specialty
certification) by 2015 or sooner.” This excludes 10,000 non–US citizen
international medical graduates (IMGs) and 3700 US citizen IMGs who seek GME
posts in U.S. teaching hospitals.
In other
words, not only will there not be enough residency training positions for
graduates of US medical schools, there will be no positions at all for IMGs and
US graduates of offshore schools.
Then
there’s this. The other day, I heard an advertisement on the radio extolling
the virtues of one of the new US medical schools and soliciting applicants for its
“charter class of 2013.”
I have been
a doctor for over 40 years. I’ve never heard of a US medical school advertising
for applicants.
The rumor
is that the school that is advertising may not be happy with many of its
applicants so far.
Could this
be a harbinger of things to come? What do you think?
10 comments:
I'm an MS4. A few months ago, a classmate and I were talking about how med school is kind of a "safe" option for smart people. If you did well in undergrad, but your passions don't point you in any single direction, you could just as easily go into business school, finance, or start your own business. Some of these options have earning potentials that far surpass medicine, but they are risky. You could go on to start the next Facebook, or you could end up being a shift manager at Arby's (if you can even find a job after graduating).
Contrast that with medical school. Unless you do something stupid to get yourself kicked out, you're almost guaranteed a residency spot somewhere and a job making $150k+ until you retire. You're saddled with an awful lot of debt, yes, but it's not so different from tens of thousands of dollars in debt being at a much lower paid job or being unemployed. In that sense, medical school isn't much of a gamble and it's a pretty safe future. But if there aren't enough residency positions in the future, that might not hold true for much longer.
Note: I'm not saying I chose medicine for the money, or that anyone should. I'm excited for my future in radiology (up to you if you still want to call a radiologist a "doctor"), but I didn't feel like medical school was my only option after undergrad.
Thanks for the thoughtful comments. I agree with what you said including the part where there might not be a residency slot for every US grad pretty soon.
It's going to be hard to pay down that med school & college debt as a barista.
Maybe it will turn out like Germany where there are so many docs that just about every ambulance has one.
Great Post. I have a solution. More Cardiothoracic Surgeons! There seems to be a dwindling amount of interest in the field and fellowship slots are not being filled. Also, are the few new cts fellows prepared to deal with our increasingly older and complex patients? Im talking the third time redos, triple valve pseudotransplants and the (gasp! ) TAVRs gone wrong. The days of the simple 3 vessel Cabg are over.
I wish for the sake of my beloved specialty, we find more good docs to take care of us in the future.
Karen Calcaño PA-C @heartsurgerypa
Karen, thanks for commenting. The problems with CT surgery are 1) at 7 years of residency, it takes to long to become one and 2) fewer heart operations will be done as more stents take over.
Sorry if this is mentioned and I just missed it, but what is the likelihood that there will be an increase in the number of residency programs? I imagine it is a process for new programs to become approved, is there any public disclosure made about how many new programs are in the works?
The number of new programs is being increased and existing to grams are expanding. The problems are that funding from Medicare may be reduced and the quality of new programs is questionable in some cases. It's not clear if new programs will survive without funding.
This is a frightening prospect considering I was just accepted to the class of 2017.
The debt is bad enough.
I keep saying this again and again, we don't need new medical schools. We need cheaper medical schools. Filling the primary care gap is all about making medical education affordable.
I would like to think that something will be worked out by 2017. So far though, that has not happened and there continue to be hints of further Medicare (the source of money for graduate medical education) budget cuts.
if we keep the amount of specialty residency positions the same and just increase the primary care residency positions, won't that address the primary care shortage problem in the US? wasn't that the intent of increasing the amount of medical students?
another option is to go dental and have graduating medical students pay for certain residency spots. I am NOT a huge fan of this plan but then again it serves a need and is a potential solution. Then again it would favor richer kids being able to go into "richer" specialties and furthering the income inequality gap here in the US.
Your plan to just increase the number of primary care slots is a good one. I foresee a problem though. I am not aware of large numbers of primary care physicians either competent or eager to train new PCPs. BTW, this is also true of most other specialties.
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