FYI....U.S. Medical Schools Should Raise Enrollments to Fill

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justanotherjerseygirl

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Friday, July 21, 2000

U.S. Medical Schools Should Raise Enrollments to Fill
Residencies, Physician Argues

By KATHERINE S. MANGAN

Medical schools in the United States aren't producing nearly
enough graduates to fill entry-level residencies, and should
consider increasing their enrollments, a physician argues in
this week's New England Journal of Medicine.

For the past two decades, medical schools have graduated about
16,000 aspiring doctors a year. That's 28 percent short of the
22,320 entry-level residencies filled by new physicians last
year.

Graduates of foreign medical schools filled 25 percent of the
new residencies. The remaining 3 percent were filled with
graduates of osteopathic schools, which emphasize such
nontraditional techniques as manually manipulating the body to
fight disease.

The author of the New England Journal article, Fitzhugh
Mullan, is a former director of the Bureau of Health
Professions. He thinks it's time the United States reduced its
reliance on foreign-trained medical graduates and produced
more of its own.

"Teaching hospitals have hired thousands of graduates of
medical schools elsewhere in the world, despite the large
numbers of competent young people unable to obtain a medical
education in this country," writes Dr. Mullan, who now writes
for the journal Health Affairs.

The president of the Association of American Medical Colleges,
Jordan J. Cohen, calls the idea "intriguing," but impractical.
The reason? Medical schools are struggling financially
already, and accepting more students would only exacerbate
their problems, he says.

"The idea of increasing class sizes at a time when resources
are severely constrained is very troubling," he adds.


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cool. that is what i have been talking about for the last few weeks!

Somebody actually published an article about that, i am pleased. I suppose that I am simply smarter than those who disagreed with me, I can actually see something that normal people haven't been able to understand.
 
Members don't see this ad :)
youngjock, you mistaken genius.

you might be one of the lucky ones with bad grades and low mcat scores who get accepted to medical school by what you've told the adcoms in your essay, and in your extracurrics.

by the way, do you suffer from ADD/hyperactivity?

-raindodger

Einstein flunked his physics classes and look at how much he taught us.
 
i just read the article. it makes you wonder when will the adcom start increasing enrollment if they agree with ideas supported by this article.

 
By attacking me personally, it just shows how low you are.

Apprently, you can not argue with resonable support, that is why you had to use that unscrupulous technique which does not work on me.

Originally posted by raindodger:
youngjock, you mistaken genius.

you might be one of the lucky ones with bad grades and low mcat scores who get accepted to medical school by what you've told the adcoms in your essay, and in your extracurrics.

by the way, do you suffer from ADD/hyperactivity?

-raindodger

Einstein flunked his physics classes and look at how much he taught us.

 
justanotherjerseygirl;

The article that you posted is obviously not well researched. I was surprised that the NEJM would publish this, (but it is simply a letter to the editor).

Increasing medical school enrollments to meet available residency spots makes no sense for several reasons:

1) There is already a glut of physicians in the US. The reason there aren't enough physicians in some locations is really a problem of distribution not of supply. To compound this problem, the simple rules of supply and demand don't apply to health care. This is where arguments for allowing the market forces to determine who has a successful practice fall apart. Physician economics are determined by supply induced demand. [Example: Compare US and Great Britan health care: There are several times more cardiologists per capita in the US than Great Britan. Although the incidence of coronary artery disease is equal in both countries, a US patient is 6 x's more likely to undergo PTCA than an English pt.]
This cost is passed directly and indirectly to the US population.

2) The physician population in all other countries is determined by medical school enrollments. The US physician supply is determined by the number of residents in GME. Who's to say that if US medical school enrollments are increased to fill currently available residency slots, that more won't be created... Teaching hospitals are paid for training residents by Medicare to the tune of two to three times the individual resident's salaries. (A true fleecing of America). And although funding for GME is sanctioned through legislation (comes from taxpayers pocketbooks) the number of residency slots is not! If a teaching hospital desires to increase the number of residency slots, it simply needs to submit the request through the residency review committee, a non-government sanctioned entity. In a time when hospitals are losing money through decreased insurance reimbursements, increasing residency positions is a revenue generator on several fronts: cheap, highly trained labor whose procedures are billable to insurance companies as well as direct reimbursement through Medicare.

3) SO the American public is paying to train more physicians than the US needs, 25% of whom are not US citizens and have not contributed revenue to the US tax pool to contribute to their own salaries, in a time when there already are too many physicians in the US. And as the physician population increases, those costs are also passed onto the US public directly and through increased insurance premiums, decresed employee benefits, and greater numbers of uninsured...

The logical answer is to decrease the number of the US medical school positions by 20% (as already advised by the Pew Commision) and decrease the number of residency positions accordingly to 110% of US med graduate positions.
 
Wow, I have to agree. Brilliant post!! The former person seems to imply that using our residency programs to train foreign doctors is a bad thing. We have some of the greatest teaching institutions in the world, and American doctors aren't exactly lining up to practice in another country. Now if we could just get our law schools filled with people who will ultimately leave the country, we'd really be on to something!
 
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