Friday, August 5, 2016

Shortage of doctors in the future? Maybe

Shortage of residency positions for international medical school graduates in the future? Yes.

Google “shortage of doctors” and you’ll find that almost everyone believes what the Association of American Medical Colleges (AAMC) says—that we will need 90,000 to 130,000 more doctors by the year 2025.

There are a few naysayers such as Gail Wilensky, a health economist and co-chair of the Institute of Medicine panel that found no evidence to support those estimates and Princeton health economist Uwe Reinhardt, who says it’s in the best interests of the AAMC to predict a shortage.

A 2012 survey found that one-third of US physicians planned to retire by 2022. According to a study by the Kaiser Family Foundation, there are just over 900,000 active physicians in the US, meaning that if the survey is correct, about 300,000 doctors will have stopped practicing by 2022.

The AAMC says that about 18,000 medical students graduated from US schools in 2015. Will that be enough to replace those who say they are quitting? The number of residency positions available for med school graduates was 27,860 in the 2016 match.

If you multiply 27,860 residency slots x 10 years (between the years 2012 and 2022) you get 278,600, which approaches the projected number of 300,000 retirees lost.

No matter which side of the debate is correct, international medical graduates (IMGs) will be adversely affected. Here is why.

According to Wikipedia and Becker's Hospital Review, more than 40 MD or DO medical schools will be opening in the next few years. That is in addition to the 10 or 12 new schools that have already admitted their first classes. Established schools are also increasing class sizes to meet the perceived demand.

Using conservative hypothetical numbers, the 40 or so new US schools plus the increased class sizes of other schools will turn out at least 3000 to 4000 more new grads per year to compete for residency programs as of 2022.

The number of residency positions is unlikely to increase as dramatically because additional government funding for residency training has not been forthcoming.

Here is the breakdown of the 2016 match by types of individuals filling positions.

Of the 2869 US IMGs placed, 896 were graduates of St. George’s and 778 graduated from Ross. That means 58% of US IMGs matched in 2016 were from just two Caribbean schools.

As US MD and DO schools start cranking out their 3000 or 4000 extra grads, fewer residency positions will be available for all other groups.

Consider your career choices carefully, my friends.

If you haven't read it, see this post on residency prospects for IMGs.


Anonymous said...

This is Dr.Muchogusto, twitter. Wow, 40 new meds schools btwn MD/DO! I cannot understand why a US citizen would consider carib or other foreign schools when there are more opportunities available here in the states. Previously the issue was lack of understanding of DO programs and possibly limited number of MD programs in a few states. Or high competition in over populated states such as cali or NY. This is no knock on DO programs either, I am just saying people know more about it now. Regardless what the future holds, I do believe a few spots, even if it is a couple hundred should allow FMG's to come here. I am talking about the Indian or Chinese dude who grew up in his or her country. Over the yrs of meeting residents, I am just really impressed with some docs who finished training in their country and they have something to contribute to our healthcare system from the get go, why not! Bring them over, it encourages residents less experienced to discuss/learn from a co-res who is exp. We know most attending do not always have time to teach, our population will only grow. I feel the door should never be completely closed on FMG's for this reason. I know there are FMG's who come here with no training from their country as well. I personally have found them to hit or miss, but those who finished residency and are ambitious to do another res here in the states, wow!

Skeptical Scalpel said...

I share your feelings. The problem is that you never know what you will get. But in truth, the same can be said for many US grads too.

William Reichert said...

I worked for a time with an internist from Ethiopia. That dude knew more about syphilis than I knew about CHF. I learned a lot.I agree with Anonymous, alias Dr. Muchogusto.On the other hand I worked with some "specialists " from China who were clueless even about issues dealing with their own specialty. Best not to generalize. This is difficult, I realize, in today's political climate
which assigns individuals to tribal groups and defines people by their assigned tribal identities rather than by the more nuanced
policy of treating folks as individuals.

Anonymous said...

Anonymous Europe: Diversity can be a two edged weapon as it was already mentioned- from absolute useless to absolute ingenuity. Actually that is what made the US great- by calling in and settling in the brightest minds of the given period (Einstein sound familiar?, Fulbright scholarship?:)
What I would add is that by working somewhere else is always good no matter where you end up, may it be some huge clinic or some little town hospital. You see and do things you would not do in your "own" institution and you get experience, which is more valuable than gold.
This was one of my earliest lessons. No matter how many books you read, untill you have experienced the actual situation/case/patient it will only be passive knowledge.
Besides, what I have to add as a cultural cross breed: Working hours for doctors in the US may truly be scary for someone not from the neighborhood...:)

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