'More doctors fail to land residency positions after school'

[W19]

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http://news.yahoo.com/more-doctors-fail-land-residency-191849186.html

I guess people are starting to take notice...

A poorly written BS anyway...

 

[Lord Humongus]

8,000+ unmatched? Sounds like they are counting IMGs and FMGs. Who, frankly, should not match.

I just hope this isn't the start of a concern trolling media campaign to increase residencies. Makes me think back to all those 'STEM shortage' shilling that was all the rage a few years ago to increase H1B visas and flood us with more cheap labor.

 

[piii]

Sensational bs article not differentiating AMG from FMG/IMG. 20k graduating US students for 30k residency spots. Not worried lol

 

[username456789]

Sensational bs article not differentiating AMG from FMG/IMG. 20k graduating US students for 30k residency spots. Not worried lol

You probably should be. This is likely all part of a push to increase residency positions, which will help flood the market with physicians and have us go the way of the lawyers.

 

[deleted731525]

You probably should be. This is likely all part of a push to increase residency positions, which will help flood the market with physicians and have us go the way of the lawyers.

I think the situation plaguing law is more complicated than the oversupply we hear about. There are a ton of "lawyers" but not a ton of well trained lawyers. Its actually almost the opposite problem of what you fear happening in medicine(too many residencies leading to too many fully trained doctors). There is nothing like residency for lawyers, and law school doesnt teach you how to actually be a lawyer, so the training falls on the first employer, whether it be a big law firm, government agency, small law firm or business. That first employer is the closest thing there is to a residency for new lawyers, where they can actually learn how to practice their craft. The problem is that there are too few employers that take inexperienced grads relative to the yearly total of graduating law students. The older lawyers that I know(and the lucky few younger ones) that were able to get a law gig out of school are all doing fine in private practice or government work. I dont think most lawyers who were able to actually get training in how to practice are struggling. So I think medicine would only be comparable to law if we had a situation where there were twice as many US grads as residencies available. That being said more residency spots might be a bad thing as well, I just dont think it is comparable to the problem law faces.

 

[Lord Humongus]

I think the situation plaguing law is more complicated than the oversupply we hear about. There are a ton of "lawyers" but not a ton of well trained lawyers. Its actually almost the opposite problem of what you fear happening in medicine(too many residencies leading to too many fully trained doctors). There is nothing like residency for lawyers, and law school doesnt teach you how to actually be a lawyer, so the training falls on the first employer, whether it be a big law firm, government agency, small law firm or business. That first employer is the closest thing there is to a residency for new lawyers, where they can actually learn how to practice their craft. The problem is that there are too few employers that take inexperienced grads relative to the yearly total of graduating law students. The older lawyers that I know(and the lucky few younger ones) that were able to get a law gig out of school are all doing fine in private practice or government work. I dont think most lawyers who were able to actually get training in how to practice are struggling. So I think medicine would only be comparable to law if we had a situation where there were twice as many US grads as residencies available. That being said more residency spots might be a bad thing as well, I just dont think it is comparable to the problem law faces.

Bro, it is exactly comparable to the situation law faces. Medical school + residency is the full path of medical providers. American law school + passing bar exam is the full path of lawyer minting. It's not that there aren't enough residency equivalent entry level jobs to train the requisite number of lawyers. You had plenty of fully trained lawyers with years of experience being fired after the 2008 crash. There is simply an oversupply of lawyers out there. Please don't make the mistake of believing that medical providers are somehow the only people on the face of the planet immune from the law of supply and demand. You increase supply, and the "price" drops. And the "price" is how much they pay you.

 

[Seth Joo]

http://news.yahoo.com/more-doctors-fail-land-residency-191849186.html

I guess people are starting to take notice...

A poor written BS anyway...

Its mostly the IMGs that are failing to land a residency these days, but in another 10 years I think the DOs will be the next to be left out of residency in good numbers. I do not think the merger is particularly beneficial to DOs because so many AOA programs are closing down and so many new DO schools are opening up. The reason why the DO degree began to get respect is because DO schools began to up their game a lot in terms of quality and the MDs began to recognize this, the AOA cashed in on this and just decided in printing new DO schools left and right.

There are a few people at my school who don't match right out of school but usually do an internship and then go somewhere.

I also want to add my own opinion that the Affordable Care Act has made really changed things for the worse for physicians and for residency prospects, as future physicians we will earn less money, also its harder to match to where we want, also for those who went overseas they are out in the cold. Also the whole student loan deal is actually a lot worse now giving it all to the government, the costs of going to school just keep going up, even though most private lenders have been shut out since 2008.

 

[PhillyMed777]

such an incredibly bad article. whoever the idiot is that wrote it just threw down a couples numbers and called it a night.

 

[Psai]

Yahoo published this crap? I don't expect the new yorker or the atlantic but 4 sentences is an embarrassment, not a news article

 

[Kaustikos]

Wow. You guys seem to think that med schools increasing accepted applicants with an incredibly stagnant number of residency spots won't affect anyone. Yes, I'm sure IMG peeps are taking the majority of the effect. But there are an increasing number of unmatched AMG people. It is increasing. The article blows it out of proportion, but don't be blind to the reality: More med students and same number of residency spots means you will feel it. I know of at least a dozen schools whom had a ridiculous increase in unmatched students. Things do need to change because people in medical school who graduate ARE competent enough to be doctors.
It's almost embarrassing that people say we need more doctors and say increase med student acceptances but omit residency spots.

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[Kaustikos]

Side note: I'm not trying to argue but looking out for those in medical school who aspire to be doctors. There's nothing right about crushing their dreams when they've made it this far.

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[username456789]

Wow. You guys seem to think that med schools increasing accepted applicants with an incredibly stagnant number of residency spots won't affect anyone. Yes, I'm sure IMG peeps are taking the majority of the effect. But there are an increasing number of unmatched AMG people. It is increasing. The article blows it out of proportion, but don't be blind to the reality: More med students and same number of residency spots means you will feel it. I know of at least a dozen schools whom had a ridiculous increase in unmatched students. Things do need to change because people in medical school who graduate ARE competent enough to be doctors.

The problem starts with the very fact that medical schools have increased their enrollment and increased in number. Just because this series of bad decisions were made doesn't mean we should sabotage all physicians by drastically increasing the number of residency spots that pump out doctors yearly.

It's almost embarrassing that people say we need more doctors

We really don't.

 

[charmiedermie]

http://news.yahoo.com/more-doctors-fail-land-residency-191849186.html

I guess people are starting to take notice...

A poorly written BS anyway...

How does 4 sentences count as an article and make it on Yahoo News? That chart is terribly formatted.

 

[Kaustikos]

The problem starts with the very fact that medical schools have increased their enrollment and increased in number. Just because this series of bad decisions were made doesn't mean we should sabotage all physicians by drastically increasing the number of residency spots that pump out doctors yearly.




We really don't.

How is it sabotage when there are many hospitals who do want more residents or can handle the increase? Rural programs are begging for this (and so are students like myself who would've gotten way better training in surgery).
Yes, we do need more doctors. I don't get why you said that. Please elaborate.

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[charmiedermie]

Wow. You guys seem to think that med schools increasing accepted applicants with an incredibly stagnant number of residency spots won't affect anyone. Yes, I'm sure IMG peeps are taking the majority of the effect. But there are an increasing number of unmatched AMG people. It is increasing. The article blows it out of proportion, but don't be blind to the reality: More med students and same number of residency spots means you will feel it. I know of at least a dozen schools whom had a ridiculous increase in unmatched students. Things do need to change because people in medical school who graduate ARE competent enough to be doctors.
It's almost embarrassing that people say we need more doctors and say increase med student acceptances but omit residency spots.

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They'll be quick to label them as stupid, those with red flags or don't deserve residency. It's their go-to response. First step should be only American graduates from American med schools can apply to American residencies.

 

[username456789]

How is it sabotage when there are many hospitals who do want more residents or can handle the increase? Rural programs are begging for this (and so are students like myself who would've gotten way better training in surgery).
Yes, we do need more doctors. I don't get why you said that. Please elaborate.

I don't get why you think we need more doctors. Did someone in the AMA tell you that?

Don't let whatever disappointment you felt on match day cloud the picture for you. We start flooding the market with physicians and we go the way of the lawyers.

 

[Kaustikos]

They'll be quick to label them as those with red flags or don't deserve residency. It's their go-to response. First step should be only American graduates from American med schools can apply to American residencies.

Well,
If you hear the cold hard truth: some residencies deliberately take IMG because they can "make them" work more hours or abuse them. But I agree. IMG don't help the problem... And I'm sorry if I offended any of them here. But come on.

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[Kaustikos]

I don't get why you think we need more doctors. Did someone in the AMA tell you that?

Don't let whatever disappointment you felt on match day cloud the picture for you. We start flooding the market with physicians and we go the way of the lawyers.

First: I hate the AMA. They don't help anything but stroking their egos.
Second, I don't know where you're getting the notion that more doctors means the same as lawyers. Residency trained physicians offer a lot. And no rural hospital will disagree. I mean, of you're talking urban or academics, then maybe. But there's a reason why the outside hospitals are willing to pay your entire debt if you work for them. They want/need the help. EM/IM/Surgery/FM are in high demand.

Edit: are you an admin?
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[username456789]

First: I hate the AMA. They don't help anything but stroking their egos.
Second, I don't know where you're getting the notion that more doctors means the same as lawyers. Residency trained physicians offer a lot. And no rural hospital will disagree. I mean, of you're talking urban or academics, then maybe. But there's a reason why the outside hospitals are willing to pay your entire debt if you work for them. They want/need the help. EM/IM/Surgery/FM are in high demand.

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This discussion has been had in great detail the past week or two somewhere on the Allo board. The problem is with distribution, not sheer numbers. Increasing the number of physicians in the hopes of them all going to underserved areas is a pipe dream; the sheer magnitude would have to be staggering and necessarily result in crippling economic situations for physicians everywhere else. It would literally have to be their last or only choice. We need better incentives to attract physicians to these areas. We absolutely do not need to pump out more and more doctors with the hopes that we'll get lucky and they'll magically decide these places are where they prefer to live and work.

You're falling for the same fallacy that led NPs to gain more and more ground. Legislators erroneously assumed that NPs were sincere in wanting to go where many physicians wouldn't. Turns out we are all human.

 

[charmiedermie]

Well,
If you hear the cold hard truth: some residencies deliberately take IMG because they can "make them" work more hours or abuse them. But I agree. IMG don't help the problem... And I'm sorry if I offended any of them here. But come on.

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I'm not against IMGs personally, but they come in under very different circumstances, many times not having paid any tuition for med school or have federal student loans where the taxpayer is on the hook. Some of them specifically come here to train for residency and then go back to their home countries because they can demand a higher salary being American trained. Residencies are fully govt. taxpayer funded and recipients of those residencies are supposed to give their care to the American public.

 

[Kaustikos]

This discussion has been had in great detail the past week or two somewhere on the Allo board. The problem is with distribution, not sheer numbers. Increasing the number of physicians in the hopes of them all going to underserved areas is a pipe dream; the sheer magnitude would have to be staggering and necessarily result in crippling economic situations for physicians everywhere else. It would literally have to be their last or only choice. We need better incentives to attract physicians to these areas. We absolutely do not need to pump out more and more doctors with the hopes that we'll get lucky and they'll magically decide these places are where they prefer to live and work.

You're falling for the same fallacy that led NPs to gain more and more ground. Legislators erroneously assumed that NPs were sincere in wanting to go where many physicians wouldn't. Turns out we are all human.

I get that point. But what unmatched students would not do residency in these locales?
I am definitely not saying I have a perfect solution. But what I am saying is medical students shouldn't have
a) a degree that's worthless
b) not be able to receive the training to be doctors.
I mean, even an MD can't really get you a good job in research. If anything, help the students get somewhere.
But this is a pipe dream for you guys. Schools just want to get paid...

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[charmiedermie]

This discussion has been had in great detail the past week or two somewhere on the Allo board. The problem is with distribution, not sheer numbers. Increasing the number of physicians in the hopes of them all going to underserved areas is a pipe dream; the sheer magnitude would have to be staggering and necessarily result in crippling economic situations for physicians everywhere else. It would literally have to be their last or only choice. We need better incentives to attract physicians to these areas. We absolutely do not need to pump out more and more doctors with the hopes that we'll get lucky and they'll magically decide these places are where they prefer to live and work.

You're falling for the same fallacy that led NPs to gain more and more ground. Legislators erroneously assumed that NPs were sincere in wanting to go where many physicians wouldn't. Turns out we are all human.

If you have enough residencies, you eventually push the graduates of those residencies into rural areas since there are only so many attending positions in the cities. They can still practice.

 

[username456789]

I get that point. But what unmatched students would not do residency in these locales?
I am definitely not saying I have a perfect solution. But what I am saying is medical students shouldn't have
a) a degree that's worthless
b) not be able to receive the training to be doctors.

It's extremely irresponsible on the part of the medical schools to increase the number of medical students to a point where AMGs outnumber residency slots.

It's doubly irresponsible for us to think that the rest of the practicing and soon to be practicing physicians owe it to some of these students to accept an over saturated market with less pay and less autonomy.

 

[username456789]

If you have enough residencies, you eventually push the graduates of those residencies into rural areas since there are only so many attending positions in the cities. They can still practice.

That was exactly my point. Except that by the time you've created the kind of leverage needed to push those graduates there, you will have already flooded all other areas and likely driven salaries into the ground.

It's very dangerous to think that "all we need to do is keep making more and more doctors and eventually they'll have no choice but to go to underserved areas."

 

[Kaustikos]

That was exactly my point. Except that by the time you've created the kind of leverage needed to push those graduates there, you will have already flooded all other areas and likely driven salaries into the ground.

It's very dangerous to think that "all we need to do is keep making more and more doctors and eventually they'll have no choice but to go to underserved areas."

Then just send the IMG peeps to rural areas. Bam. Problem solved (not really).

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[charmiedermie]

Then just send the IMG peeps to rural areas. Bam. Problem solved (not really).

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I really think there are enough smart, intelligent, and hardworking rural American born med students who would go to rural areas and actually stay their long term, rather than IMGs who rotate out, once their green card comes thru after x number of years. They'd probably be happier providers since they are giving back to their own communities.

 

[DrHalsey]

I really think there are enough smart, intelligent, and hardworking rural American born med students who would go to rural areas and actually stay their long term, rather than IMGs who rotate out, once their green card comes thru after x number of years. They'd probably be happier providers since they are giving back to their own communities.

Very few people opt to go 400k in debt and eat way 10+ years of their life to "give back". Sure a few will go, but when you can make so much more somewhere else? Not happening. There is a reason the shortage exists right now.

 

[Commer_Knocker]

I was reading how med school classes are slotted to increase at 2.4% and residency position to increase at 1.6%(NEJM); it'll be quite some time before they converge or any type of shut-out happens. That said, this assumes that additional state and federal funding towards residencies doesn't dry up; it also assumes the number of seats at US medical schools will keep expanding in the same way they boomed from 2000-2014, which may not be the case.

What most people didn't anticipate in 97 when they passed the BBA and limited the number of spots was that states would step in and fund programs, either through Medicaid expansions, direct funds, or otherwise. Also, you have lots of other federal funding, ie VA, Obamacare, Medicaid, etc- not exactly intended in the beginning, but how it worked out.

I don't really buy into the non-sense that a "GME Squeeze" is coming, nor do I buy the argument that we need more residency positions or more money thrown at GME. I don't really think the yahoo article linked above proves anything we didn't already know- that it's getting harder to match as an FMG and that we have more US-grads. I think most of the growing number of "unmatched applicants" were FMGs, either because more were applying or more were getting rejected because of a contracting US-grad/spot ratio, or both. That said, there were still ~7,000 spots last year that went to FMGs, so I don't think we need to be worried as US-grads about finding a spot. The only implication we should concern ourselves with though is that some specialties won't be as wide open as they used to be.

 

[iDOliveinMD]

.

 

[drkristy85]

I really think there are enough smart, intelligent, and hardworking rural American born med students who would go to rural areas and actually stay their long term, rather than IMGs who rotate out, once their green card comes thru after x number of years. They'd probably be happier providers since they are giving back to their own communities.

IMG's only stay for 2 years until they get their green card. And yes, we do need to attract more rural-born students to med school. In the same way that schools have affirmative action and quotas on minorities, there should be some sort of incentive/quota on at least accepting some rural students into each school

 

[drkristy85]

Very few people opt to go 400k in debt and eat way 10+ years of their life to "give back". Sure a few will go, but when you can make so much more somewhere else? Not happening. There is a reason the shortage exists right now.

Actually you can make "so much more" working in a rural area. They typically pay double what you would earn in a bigger city. Plus cost of living is half as much, so it is really like you are earning 3-4 times as much in terms of your lifestyle. And the government gives you additional loan repayment money for working in an underserved area. So rural docs pay off their loans fast. The ones that I know live in gigantic mansions which are more akin to castles really. And they drive very nice cars. Some of these are actually primary care doctors in rural areas who are being paid very very well.

 

[charmiedermie]

Very few people opt to go 400k in debt and eat way 10+ years of their life to "give back". Sure a few will go, but when you can make so much more somewhere else? Not happening. There is a reason the shortage exists right now.

What US medical school are you going to where you are coming out with 400K of student loan debt on graduating? Rural places give a lot of perks, more than cities, in attending salary and other things. Rural people will naturally want to stay close to family and their home roots. For them, its a no brainer to go back with all positives. How many American rural med students do you think populate med school classes? Not many and we need and should bring in more.

 

[Commer_Knocker]

Part of the problem I think though is that rural hospitals are closing at a faster rate in recent years, with many more in danger. They can't make the margins to stay in operation. I'd imagine this affects the number of rural spot available, as well as the shortage of rural practitioners.

 

[DrHalsey]

Actually you can make "so much more" working in a rural area. They typically pay double what you would earn in a bigger city. Plus cost of living is half as much, so it is really like you are earning 3-4 times as much in terms of your lifestyle. And the government gives you additional loan repayment money for working in an underserved area. So rural docs pay off their loans fast. The ones that I know live in gigantic mansions which are more akin to castles really. And they drive very nice cars. Some of these are actually primary care doctors in rural areas who are being paid very very well.

I know what you mean since I grew up in an area like that but somehow there is still a shortage of physicians in the area no? It seems the graduates still prefer to live the high life closer to the city at least in the short term.

I know I would probably return to the area I grew up in or some other rural area since it is what I know and am I am more comfortable there.

 

[charmiedermie]

I know what you mean since I grew up in an area like that but somehow there is still a shortage of physicians in the area no? It seems the graduates still prefer to live the high life closer to the city at least in the short term.

I know I would probably return to the area I grew up in or some other rural area since it is what I know and am I am more comfortable there.

That's because we don't recruit many rural med students overall.

 

[Whats up Doc!]

F Yahoo the only credible news source out there is the onion

 

[DocToBe2018]

It defies common sense that we should have AMGs not matching. All AMGs to a certain degree deserve seats in the medical school. I don't understand why FMGs who have never paid a penny of tax to Uncle Sam be allowed to compete equally with the AMGs. I know of FMGs who take a whole year of leave to study for the Steps when I barely get few weeks at most between M2 and M3 years. At least the IMGs who went the Carib route are one of us. Residency matching should be staggered so that the FMGs have a separate chance to match to slots that are not filled by the US citizen candidates. I can only imagine what it is like to extend your 120% for 4 years of undergrad, 4 years of med and then not match to a residency. Of course, the debt is an icing on the cake.

 

[VarysLives]

I live in a "desirable" suburb outside a major city. There is a doctor shortage here. It takes 6-8 weeks to get a primary care appointment. The ACA has brought many more people onto patient rolls, and that's without considering increasing need for chronic care among aging baby boomers. For the next 10-20 years, the supply of patients will continue to outstrip the supply of providers.