lol @ "doctor shortage"

[SpecterGT260]

yes he can..... People often correlate things inappropriately and draw conclusions therein. This is why an alternative explanation for findings stands as an appropriate counter-argument. think "null hypothesis". In testing it is not sufficient only to support your hypothesis. You must also be able to reject your null hypothesis. The existence of an artificial influence like an outwardly controlled number of residency seats to match demand would not support the claim that low unemployment means shortage.

It is like saying a college town doesnt have enough bars because they are at a 1-in 1-out policy at the door. This is controlled by a separate set of criteria (fire code) so it is inappropriate to draw this conclusion.

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[Morsetlis]

A plausible alternative explanation does not dismiss the other plausible alternative explanation. It does prevent the other plausible alternative explanation from being the only possible explanation, but it does not prevent the other plausible alternative explanation from being an explanation at all!

Low unemployment does not necessary mean shortage, but it could mean shortage, and an alternative explanation does not disprove the shortage unless it specifically disproves the shortage AND alternatively explain. Besides we're all hand-waving anyway with no way to conclusively prove it.

I don't believe there is a shortage of physicians, yet. I also can't read the future.

 

[SpecterGT260]

I think you missed my point. It does not dismiss the other explanation but it dismisses the statement that explanation 1 is the sole explanation. I.e. you cannot prove it is your way until you prove it is not my way

 

[auburnO5]

You guys are nerds, just an FYI

 

[SpecterGT260]

You guys are nerds, just an FYI

That's one of the nicest things anyone has said to me today!

 

[deleted103644]

I'm disappointed in all of you for ignoring my Breaking Bad reference.

Watch it, it's the best show on TV.

 

[SteinUmStein]

I'm disappointed in all of you for ignoring my Breaking Bad reference.

Watch it, it's the best show on TV.

I think I will after Step 1. You're probably the 5th person to tell me to watch that show. The last show I ignored for far too long was Arrested Development, and I can't believe I waited so many years to watch that.

 

[deleted103644]

I think I will after Step 1. You're probably the 5th person to tell me to watch that show. The last show I ignored for far too long was Arrested Development, and I can't believe I waited so many years to watch that.

I'd also recommend the League, but that's a completely different genre.

Basically, stick to AMC, FX, HBO and Showtime and you can't do much wrong.

 

[SteinUmStein]

I'd also recommend the League, but that's a completely different genre.

Basically, stick to AMC, FX, HBO and Showtime and you can't do much wrong.

Yeah, the Walking Dead season 2 helped make M2 year less painful.

 

[The kitchen sink]

OP, you have a sick username.

 

[nysegop]

For the last couple of years, I've always been hearing "there's a doctor shortage in this country".

Then why the hell is EVERY SINGLE RESIDENCY PROGRAM I CONTACT TELLING ME THAT THEIR PROGRAM IS FULL?

What "shortage"? Again, .

Yeah but still, 90%+ of students get residency. And the 10% that don't will usually just take a year off and reapply. But yes, I agree there is no huge shortage of doctors.

 

[Knicks]

Well,
I don't know aboout a shortage, but I got a clinical job working a 4 day week for 200+K in 4 hrs of looking. I am a researcher by trade, but have gone into clinical work becasue I actually enjoy taking care of people, and I have horses to feed!

Internists can expect anywhere between 120K on the very low end to 250K to start.

But as I told my med students if you really want the big bucks , go to law school and sue Drs!

Well aren't you the lucky one

OP, you have a sick username.

 

[KnuxNole]

Too bad the Heat are gonna kill them

 

[FSU2013]

It's also more of a predicted shortage. As many of these aging physicians retire in the coming years, there's going to be quite a drastic drop off. And unfortunately the smart people in control of the government realized this and decided it best to up med school enrollment. Unfortunately this does not work without increasing residency spots, which has yet to be done.

These two words should never be uttered in the same breath.

 

[OveractiveBrain]

These two words should never be uttered in the same breath.

The sad reality is

1. The number of physicians retiring are doing so at a greater rate than new ones being trained. The field has changed so much, people are leaving younger.

2. The workpower of the new physicians is less. Work-life balance is now important. Work-hour restrictions teach residents that you don't have to be working all the time. So, even if the number of physicians weren't changing, the amount of work any one given physician is doing is decreasing.

3. The population requiring more frequent care is growing. Baby-boomers are here. There are going to be more people in that irritatingly difficult to manage geriatric population with multiple comorbidities than ever before, which will demand more physicians to support them.

4. There are now more medical students being admitted to the class of 2016 than there are PGY-1 spots (excluding preliminaries). Yes. In 2016, the number of US medical graduates will exceed the number of residencies that there are. Forget FMGs. Forget Americans in the Carribean. There wont be enough PGY-1 spots for american medical students who graduate from an american medical school.

There is most certainly a physician shortage. That shortage is going to get worse, both in terms of numbers and impact. If we do not expand residency programs to provide more physicians that role will be filled by mid-level providers, patients will suffer decreased access to care, and medical students will start killing each other for residency spots. Seriously.

 

[SpecterGT260]

The sad reality is

1. The number of physicians retiring are doing so at a greater rate than new ones being trained. The field has changed so much, people are leaving younger.

2. The workpower of the new physicians is less. Work-life balance is now important. Work-hour restrictions teach residents that you don't have to be working all the time. So, even if the number of physicians weren't changing, the amount of work any one given physician is doing is decreasing.

3. The population requiring more frequent care is growing. Baby-boomers are here. There are going to be more people in that irritatingly difficult to manage geriatric population with multiple comorbidities than ever before, which will demand more physicians to support them.

4. There are now more medical students being admitted to the class of 2016 than there are PGY-1 spots (excluding preliminaries). Yes. In 2016, the number of US medical graduates will exceed the number of residencies that there are. Forget FMGs. Forget Americans in the Carribean. There wont be enough PGY-1 spots for american medical students who graduate from an american medical school.

There is most certainly a physician shortage. That shortage is going to get worse, both in terms of numbers and impact. If we do not expand residency programs to provide more physicians that role will be filled by mid-level providers, patients will suffer decreased access to care, and medical students will start killing each other for residency spots. Seriously.

Until the ACGME bars DOs from their match

I'm just saying if you stress a system enough it is bound to break somewhere. Movements are already headed that way.

 

[KnuxNole]

The sad reality is

1. The number of physicians retiring are doing so at a greater rate than new ones being trained. The field has changed so much, people are leaving younger.

2. The workpower of the new physicians is less. Work-life balance is now important. Work-hour restrictions teach residents that you don't have to be working all the time. So, even if the number of physicians weren't changing, the amount of work any one given physician is doing is decreasing.

3. The population requiring more frequent care is growing. Baby-boomers are here. There are going to be more people in that irritatingly difficult to manage geriatric population with multiple comorbidities than ever before, which will demand more physicians to support them.

4. There are now more medical students being admitted to the class of 2016 than there are PGY-1 spots (excluding preliminaries). Yes. In 2016, the number of US medical graduates will exceed the number of residencies that there are. Forget FMGs. Forget Americans in the Carribean. There wont be enough PGY-1 spots for american medical students who graduate from an american medical school.

There is most certainly a physician shortage. That shortage is going to get worse, both in terms of numbers and impact. If we do not expand residency programs to provide more physicians that role will be filled by mid-level providers, patients will suffer decreased access to care, and medical students will start killing each other for residency spots. Seriously.

Isn't this...always important

 

[Oxer45]

Until the ACGME bars DOs from their match

I'm just saying if you stress a system enough it is bound to break somewhere. Movements are already headed that way.

That's unlikely to happen. Many hospitals, especially those in cities like NYC, has affiliations with DO and MD schools. They train both MD and DO students and residents, and have DO's in faculty, get referrals from DOs. They system is very intertwined. Its not possible for any hospital/university to exclude 15% of US doctors. What will happen however is DO's will have to open up their residency slots to MD applicants.

for fun reading, see The coming residency bloodbath :http://forums.studentdoctor.net/showthread.php?t=681809

 

[SpecterGT260]

I kind of figured it would be a "one or the other" type of situation w some old AOA codger saying "over my dead.body". But time will tell. However hospital affiliations with both school types are not the majority and if we are increasing medshool size without residency size we will be turning away 15% (or some percent) of doctors regardless of title. At such time it will be in the best political interests for the ACGME to protect their own

 

[deleted103644]

That's unlikely to happen. Many hospitals, especially those in cities like NYC, has affiliations with DO and MD schools. They train both MD and DO students and residents, and have DO's in faculty, get referrals from DOs. They system is very intertwined. Its not possible for any hospital/university to exclude 15% of US doctors. What will happen however is DO's will have to open up their residency slots to MD applicants.

for fun reading, see The coming residency bloodbath :http://forums.studentdoctor.net/showthread.php?t=681809

DOs are not very well-established in NYC (I'd never heard of one until joining SDN), and many of the hospitals that NYCOM uses for rotations are in danger of shutting down themselves (sadly most of the non-HHC Brooklyn hospitals are in this boat).

There are some DO doctors in NYC obviously, but the percentage is much smaller than in the Midwest and they are more heavily represented at troubled hospitals in NYC.

 

[Oxer45]

DOs are not very well-established in NYC (I'd never heard of one until joining SDN), and many of the hospitals that NYCOM uses for rotations are in danger of shutting down themselves (sadly most of the non-HHC Brooklyn hospitals are in this boat).

There are some DO doctors in NYC obviously, but the percentage is much smaller than in the Midwest and they are more heavily represented at troubled hospitals in NYC.

Actually all hospitals in NYC with the exception of NSLIJ and NYU are in the red and have been for few years now. The interesting thing I learned was even Columbia was in the red. (Makes sense. Since they are in Harlem, most of their population is medicaid) The city hospitals are also in the red, but since they are govt funded it really doesn't matter.

 

[deleted103644]

Actually all hospitals in NYC with the exception of NSLIJ and NYU are in the red and have been for few years now. The interesting thing I learned was even Columbia was in the red. (Makes sense. Since they are in Harlem, most of their population is medicaid) The city hospitals are also in the red, but since they are govt funded it really doesn't matter.

Oh, yeah, they're all losing money (except NSLIJ), but the Brooklyn unaffiliated hospitals are particularly in trouble. A few of them are also known to provide seriously substandard (or even dangerous) care.

I think Cornell might be profitable too, since that's where all the rich people in NYC tend to go for care. (This is also why the medical students and even residents don't get as much access to the patients...)

Columbia, NYU, Albert Einstein and Mount Sinai are unlikely to shut down as they're academic centers. Sinai had sketchy financing prior to breakup with NYU, but it seems to be solid now.

Not sure about Continuum hospitals, but they just joined a partnership of sorts with NYU that will probably get them better insurance reimbursement.

EDIT:

Didn't realize NYU was actually profitable now, interesting, but not surprising considering their recent push for patients (all the advertising for hospitals in NYC now seems to be NYU).

I'd bet Cornell is profitable too, but it's finances are tied to Columbia under the NYP banner, so they may not separate out the stats.

 

[Obnoxious Dad]

The sad reality is


4. There are now more medical students being admitted to the class of 2016 than there are PGY-1 spots (excluding preliminaries). Yes. In 2016, the number of US medical graduates will exceed the number of residencies that there are. Forget FMGs. Forget Americans in the Carribean. There wont be enough PGY-1 spots for american medical students who graduate from an american medical school.

There will be approximately 20,000 allopathic students and 5,400 osteopathic students admitted in the fall of 2012. In the 2010-2011 academic year there were 26,107 ACGME residency slots, excluding transitional and preliminary slots, and 1,908 osteopathic slots after excluding traditional rotating year slots. You can find the ACGME numbers in the ACGME Data Resource Book and the osteopathic slots by noodling around www.natmatch.com.

This means there will probably be at least 28,000 total slots in four years and even with attrition as low as 2%, there will be 25,000 graduates of US MD and DO schools in 2016.

You have the number of slots wrong because most commentators ignore the osteopathic match, the San Francisco match the urology match and the 3,000 or so "out of match" slots.

I would agree, however, that going to the Caribbean will become a very bad bet for Americans.

 

[badasshairday]

I would agree, however, that going to the Caribbean will become a very bad bet for Americans.

I have a friend who is likely to be starting the caribbean very soon. I feel like it would be wrong of me to not try to at least talk him out of it. Poor guy has been trying to get into a US med school for the past 4 years. But I feel it is too risky to go overseas for the MD degree and take on a load of debt as well as a huge disadvantage when it comes to the match.

 

[SpecterGT260]

There will be approximately 20,000 allopathic students and 5,400 osteopathic students admitted in the fall of 2012. In the 2010-2011 academic year there were 26,107 ACGME residency slots, excluding transitional and preliminary slots, and 1,908 osteopathic slots after excluding traditional rotating year slots. You can find the ACGME numbers in the ACGME Data Resource Book and the osteopathic slots by noodling around www.natmatch.com.

This means there will probably be at least 28,000 total slots in four years and even with attrition as low as 2%, there will be 25,000 graduates of US MD and DO schools in 2016.

You have the number of slots wrong because most commentators ignore the osteopathic match, the San Francisco match the urology match and the 3,000 or so "out of match" slots.

I would agree, however, that going to the Caribbean will become a very bad bet for Americans.

Statsroasted!

 

[loveoforganic]

There will be approximately 20,000 allopathic students and 5,400 osteopathic students admitted in the fall of 2012. In the 2010-2011 academic year there were 26,107 ACGME residency slots, excluding transitional and preliminary slots, and 1,908 osteopathic slots after excluding traditional rotating year slots. You can find the ACGME numbers in the ACGME Data Resource Book and the osteopathic slots by noodling around www.natmatch.com.

This means there will probably be at least 28,000 total slots in four years and even with attrition as low as 2%, there will be 25,000 graduates of US MD and DO schools in 2016.

You have the number of slots wrong because most commentators ignore the osteopathic match, the San Francisco match the urology match and the 3,000 or so "out of match" slots.

I would agree, however, that going to the Caribbean will become a very bad bet for Americans.

I thought out of match slots were done with?

 

[Obnoxious Dad]

I thought out of match slots were done with?

The only thing that's actually ending is any program having some slots in the match and others outside the match. For example the pediatrics program at St. Christopher's in Philadelphia had almost all of their slots in the match but kept a few slots for FMGs outside the match. They can't do that anymore. I suspect that St. Christopher's will be "all in" in the future. Some programs that had a very tough time filling in the past may drop completely out of the match.

 

[loveoforganic]

Gotcha, thanks! Wasn't clear on that

 

[Dr Love]

The sad reality is

1. The number of physicians retiring are doing so at a greater rate than new ones being trained. The field has changed so much, people are leaving younger.

2. The workpower of the new physicians is less. Work-life balance is now important. Work-hour restrictions teach residents that you don't have to be working all the time. So, even if the number of physicians weren't changing, the amount of work any one given physician is doing is decreasing.

3. The population requiring more frequent care is growing. Baby-boomers are here. There are going to be more people in that irritatingly difficult to manage geriatric population with multiple comorbidities than ever before, which will demand more physicians to support them.

4. There are now more medical students being admitted to the class of 2016 than there are PGY-1 spots (excluding preliminaries). Yes. In 2016, the number of US medical graduates will exceed the number of residencies that there are. Forget FMGs. Forget Americans in the Carribean. There wont be enough PGY-1 spots for american medical students who graduate from an american medical school.

There is most certainly a physician shortage. That shortage is going to get worse, both in terms of numbers and impact. If we do not expand residency programs to provide more physicians that role will be filled by mid-level providers, patients will suffer decreased access to care, and medical students will start killing each other for residency spots. Seriously.

1. Doctors are leaving the field because of frustration due to low pay and massive bureaucracy. Flooding the market with poorly trained doctors will make that worse, not better.
2. With the increase in technology, physician productivity is higher. And what do you mean "work-hour restriction teach residents you don't have to work all the time"? You think people didn't know that before?
3. How long do you expect baby-boomers to survive? Should we train a generation of physicians to take care of old folks for a few years?
4. An increase in the number of med students does not make the case for an increase in residency positions. A limited number of residency positions makes the case for halting this insane increase in the number of ill-equipped med schools.

 

[phltz]

3. How long do you expect baby-boomers to survive? Should we train a generation of physicians to take care of old folks for a few years?

You've misunderstood the baby boom. There are many more baby boomers than there are people, say, 10 years older than the baby boomers. There are approximately as many baby boomers as there are people 10 years younger. Once the baby-boomer bulge reaches old age, there will be a more or less continuous stream of new old people arriving in old age for the forseeable future.

 

[mclinkin94]

I think the so-called physician shortage is a projection based on the fact that the baby boomer generation is getting older meaning that the number of sick people is set to grow exponentially over the coming decade or so.

 

[mclinkin94]

Come on all, lets face it. After we get through medical school we will be living under a bridge by a river in a mini-van.

But its okay, we are educated.


On the serious note:

Question: since when have they been making new medical schools?

If these nonexistent new medical schools have too many people to match into a residency (which is not adjusted to physician demand), why aren't there too many unemployed doctors or too many medical school graduates without a job?

OP, I think your problem is you are trying to get into a competitive residency because your job will pay more than primary care. You should go with interest, not money.

 

[SpecterGT260]

Come on all, lets face it. After we get through medical school we will be living under a bridge by a river in a mini-van.

But its okay, we are educated.


On the serious note:

Question: since when have they been making new medical schools?

If these nonexistent new medical schools have too many people to match into a residency (which is not adjusted to physician demand), why aren't there too many unemployed doctors or too many medical school graduates without a job?

OP, I think your problem is you are trying to get into a competitive residency because your job will pay more than primary care. You should go with interest, not money.

Google it.... there are at least a dozen schools opened in the last decade

 

[mclinkin94]

Google it.... there are at least a dozen schools opened in the last decade

I don't know if that is a good thing or a bad thing in my sense as a pre med! I mean more opportunity for me, but at the same time, I could graduate med school and still not get a residency. poke:

Will these new medical schools have less "requirements" or average MCAT and GPA than the older ones, meaning-will you have a higher chance to get accepted to those new medical schools?

 

[ckdgusdl88]

The number of residency spots in the country is fixed by Medicare.
Currently, the number of residency spots > the number of MD and DO graduates in this country.

Increasing MD enrollment simply makes life harder for IMGs and FMGs. It has very little material effect on the actual supply of doctors.

 

[shinbeats]

The number of residency spots in the country is fixed by Medicare.
Currently, the number of residency spots > the number of MD and DO graduates in this country.

Increasing MD enrollment simply makes life harder for IMGs and FMGs. It has very little material effect on the actual supply of doctors.

Good point

 

[Obnoxious Dad]

The number of residency spots in the country is fixed by Medicare.
Currently, the number of residency spots > the number of MD and DO graduates in this country.

Increasing MD enrollment simply makes life harder for IMGs and FMGs. It has very little material effect on the actual supply of doctors.

Not all residency spots are funded through Medicare. For example the family medicine spots in Wisconsin are funded by the state's tax payers and some residency spots in Michigan are funded by Blue Cross.

Furthermore the number of first year residents in ACGME non-prelim/transitional residency programs grew by 242 residents this year. In 2010 the number was 25,865 and in 2011 the number was 26,107. The growth rate was .9% Bazeenga!

 

[ckdgusdl88]

Not all residency spots are funded through Medicare. For example the family medicine spots in Wisconsin are funded by the state's tax payers and some residency spots in Michigan are funded by Blue Cross.

Furthermore the number of first year residents in ACGME non-prelim/transitional residency programs grew by 242 residents this year. In 2010 the number was 25,865 and in 2011 the number was 26,107. The growth rate was .9% Bazeenga!

Thanks for the correction. I guess my point was that the increasing MD enrollment does not ultimately determine physician supply - it's residency slots.

 

[eject]

but see

http://www.kevinmd.com/blog/2012/04/physician-shortage-worse.html

By 2015, the Association of American Medical Colleges estimates that the shortage of specialists will match or exceed the shortage of primary care physicians

 

[thepoopologist]

For the last couple of years, I've always been hearing "there's a doctor shortage in this country".

Then why the hell is EVERY SINGLE RESIDENCY PROGRAM I CONTACT TELLING ME THAT THEIR PROGRAM IS FULL?

What "shortage"? Again, .

How many years have you been out of medical school

 

[medstud87]

About $500 a year for ODs for $1 million/$3 million malpractice coverage. One OD missed glaucoma, didn't have insurance and got his butt batted with an aluminium baseball bat by the lawyers.

fark

 

[danopoo]

I love some of the pejorative comments [not all are belittling but some are] I find on here. I am a military physician who has been practicing primary care as a flight surgeon for 6 years. I am a DO who scored in the top 5% on steps 1 and 3, have multiple published research papers (google my name), have the respect of all of my subspecialty colleagues, graduated from Walter Reeds PGY1 Neuro internship (didn't match Rads, so I was put into PGY1 Neuro), get over 200 CMEs per year [have made the most of my time as a flight sgn] etc etc. My son became sick with DOCK8 deficiency and I had to put my residency plans on hold. Since he has received his BMT, I have barely gotten a sniff from residency programs I have applied to. I would put my clinical acumen up against any PCP with the same amount of patient care experience.

 

[Cinclus]

The people who commented on this thread did so over 3 years ago. They probably aren't keeping up with it.

 

[gmbz]

All in for the Necrobump.