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

Discussion in 'Medical Students - MD' started by justanotherjerseygirl, Jul 21, 2000.

  1. justanotherjerseygirl

    justanotherjerseygirl Junior Member

    May 30, 2000
    Likes Received:
    Friday, July 21, 2000

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


    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

    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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  3. abbeydesert

    abbeydesert Senior Member

    Apr 4, 2000
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  4. youngjock

    youngjock Banned

    Jun 13, 2000
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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.
  5. raindodger

    raindodger Senior Member

    Jun 15, 2000
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    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?


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


    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.

  7. youngjock

    youngjock Banned

    Jun 13, 2000
    Likes Received:
    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.

  8. rtk

    rtk Member

    Dec 28, 1998
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    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.
  9. rtk:

    That was a simply brilliant post.
  10. Sdonnenwerth

    Sdonnenwerth Junior Member

    Jul 25, 2000
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    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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