Im a student at Virginia Commonwealth University and I am doing a research paper on whether medical schools should accept more applicants. The statistics show that there are not enough medical students to fill entry level jobs and these spots are being filled by doctors from other countries. What is your opinion on this topic. Should more students be accepted or not. and Why?
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whether medical schools should accept more applicants? please share opinions.
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Most med schools are already stretched to the limits of their budgets. And you may have heard that many have been in serious financial trouble in the last five years or so (check out MCP). Plus, most programs are structured for exactly the same number of students each year. As in they have just enough clinical preceptors available, not to mention anatomy labs, and even number of seats in their lecture hall, etc. I actually interviewed at one school that had 90 seats in their lecture hall, so that's how many students they accepted, no more, no less. Most schools also strive to keep class sizes low, in order to improve the quality of education. And I suppose you could also say that increasing acceptances, would (to a degree) involve lowering standards.
So I guess what I'm trying to say is that the question of whether we should crank out more docs is logistically unfeasible. Even if each school could squeeze in 5 more students, that's only going to create 625 more spots, which when you're talking about 38,000 applicants is really not that much of a difference. And most schools (I think) would refuse to change their class size. So, unless you start opening new schools, I don't think enrollment will change significantly any time soon.
Mango
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So I guess what I'm trying to say is that the question of whether we should crank out more docs is logistically unfeasible. Even if each school could squeeze in 5 more students, that's only going to create 625 more spots, which when you're talking about 38,000 applicants is really not that much of a difference. And most schools (I think) would refuse to change their class size. So, unless you start opening new schools, I don't think enrollment will change significantly any time soon.
Mango
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When US medical schools go through the accreditation process, and get accredited, they are told the maximum number of students they may have. That is obviously based on the physical, financial, human resources available. No medical school can increase class size on its own volition; if it did, it would lose its accreditation. A medical school can appeal to increase class size if it chose too, but it would have to have a visiting team from the accrediting authority agree before it can do so.
Any decision to increase class sizes in US medical schools is ultimately also a political decision. I don't know the politics of it, but it is clear the US has been filling the gaps in physician availabilty by both the US citizen graduates of offshore and other foreign medical schools and non-US citizen graduates of foreign medical schools. EDITORIAL: I have always thought that those most concerned about availability of adequate and competent
health care in the US should not be going to medical school with the idea of exerting influence over those issues, but entering the "dirty" world of politics, getting elected to Congress and other bodies where they have a chance to control the purse strings and influence legislation. Those are clearly political issues in the US and have little to do with what the health professions want or believe are the best solutions. Politicians do not pay much attention to the professionals, however bright they may be. Their numbers are too small to carry enough weight when election time rolls around and when political decisions are made. For what its worth. Anyone is, of course, free to differ with me, but I will not respond in this forum.
Any decision to increase class sizes in US medical schools is ultimately also a political decision. I don't know the politics of it, but it is clear the US has been filling the gaps in physician availabilty by both the US citizen graduates of offshore and other foreign medical schools and non-US citizen graduates of foreign medical schools. EDITORIAL: I have always thought that those most concerned about availability of adequate and competent
health care in the US should not be going to medical school with the idea of exerting influence over those issues, but entering the "dirty" world of politics, getting elected to Congress and other bodies where they have a chance to control the purse strings and influence legislation. Those are clearly political issues in the US and have little to do with what the health professions want or believe are the best solutions. Politicians do not pay much attention to the professionals, however bright they may be. Their numbers are too small to carry enough weight when election time rolls around and when political decisions are made. For what its worth. Anyone is, of course, free to differ with me, but I will not respond in this forum.
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Oh my God! It's Son of Youngjock! The horror... the horror...
I posted this reply to the same question a few months ago:
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.
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.
rtk:
That was an excellent analysis. I am uncertain of the true nature of the re-imbursement system for medical residencies and I would like to know more. Where did you get your information. Do you have any Websites or literature that would highlight this issue? Thank you.
misfit
That was an excellent analysis. I am uncertain of the true nature of the re-imbursement system for medical residencies and I would like to know more. Where did you get your information. Do you have any Websites or literature that would highlight this issue? Thank you.
misfit
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Medical schools are more likely to decrease class sizes. It's all economics. Less doctors means higher demand which means higher salaries for existing doctors. Don't think that physicians are so altuistic that they don't care about how much money they make.
You always hear about new physicians that are "scared they won't be able to pay off their school loans on a primary care physician's salary". Yeah, right. What this really means is that primary care doesn't build $700,000 houses. The point is that doctors are always going to protect their territory just like any other profession. This is why medical schools will not increase class size. Don't get me wrong. I'm no different. I wouldn't be in medical school if doctors made 25K a year.
That's not my only motovation, but I do want to be duely compenstated for 11-13 years of hard work that I put into learning my profession. Not to mention the physician's contribution to society via the services that he/she provides. Thus, I'm against increasing medical school class sizes as well.
You always hear about new physicians that are "scared they won't be able to pay off their school loans on a primary care physician's salary". Yeah, right. What this really means is that primary care doesn't build $700,000 houses. The point is that doctors are always going to protect their territory just like any other profession. This is why medical schools will not increase class size. Don't get me wrong. I'm no different. I wouldn't be in medical school if doctors made 25K a year.
That's not my only motovation, but I do want to be duely compenstated for 11-13 years of hard work that I put into learning my profession. Not to mention the physician's contribution to society via the services that he/she provides. Thus, I'm against increasing medical school class sizes as well.
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Right on, Brother ike!
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It has been my theory not so many months ago.
of course, med schools should produce more doctors. there are always a no nurse shortage, why is that? because nurses are get paid much much cheaper, but they sometimes actually diagnosis patients first.
someone said that it is the economics, but that is not ture.
if there are doctors, then we should be able to pay less for health insurance, then nationwide health care expenses would be reduced.
it is the doctors and med. schools that are trying to keep the monopoly!
there are all kinds of law school some which even offer night classes, i don't see a point not to open more med. schools or accept more applicants.
of course, med schools should produce more doctors. there are always a no nurse shortage, why is that? because nurses are get paid much much cheaper, but they sometimes actually diagnosis patients first.
someone said that it is the economics, but that is not ture.
if there are doctors, then we should be able to pay less for health insurance, then nationwide health care expenses would be reduced.
it is the doctors and med. schools that are trying to keep the monopoly!
there are all kinds of law school some which even offer night classes, i don't see a point not to open more med. schools or accept more applicants.
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Howdy,
I can't remember the exact name of the organization, I think American University, which is an off shore school based in Dom Rep was looking at opening a medical/allied health university in Casper, WY. For now the project has been shelved b/c of unclear political conflicts. However, this may be the shot over the bow for breaking the monopoly of the allopathic schools in educating physicians. Within the last five or six years there have been two new osteopathic schools opened, Touro and Arizona. It would appear that while there is a push for MD schools to reduce the number of grads to keep demand high, there are those poised to fill the artificial vacuum. If the allopathic takeover of osteopathy in the sixties had worked I think that today we would have seen a reduction in the total number degrees granted.
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BSD
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Work under the assumption that you will be happy one day
I can't remember the exact name of the organization, I think American University, which is an off shore school based in Dom Rep was looking at opening a medical/allied health university in Casper, WY. For now the project has been shelved b/c of unclear political conflicts. However, this may be the shot over the bow for breaking the monopoly of the allopathic schools in educating physicians. Within the last five or six years there have been two new osteopathic schools opened, Touro and Arizona. It would appear that while there is a push for MD schools to reduce the number of grads to keep demand high, there are those poised to fill the artificial vacuum. If the allopathic takeover of osteopathy in the sixties had worked I think that today we would have seen a reduction in the total number degrees granted.
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BSD
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Work under the assumption that you will be happy one day
