Why is medical school still hard to get into if the U.S. has a shortage of physicians?

[deleted1041777]

Why is medical school still hard to get into if the U.S. has a shortage of physicians? Wouldn't schools be better off increasing the size of their student body?

U.S. physician shortage growing

A new AAMC study projects a shortfall of up to 139,000 physicians by 2033. Among the factors: older patients and retiring doctors.

www.aamc.org

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[gyngyn]

The number of current US medical school graduates does not affect the number of new practicing physicians in the US.

 

[db673]

Schools also need to get approval to increase their student body so its not that easy. Plus without increasing the number of residency spots, it would be pointless since there is already a gap between the two.

 

[FluffyCat1212]

Why is medical school still hard to get into if the U.S. has a shortage of physicians? Wouldn't schools be better off increasing the size of their student body?

U.S. physician shortage growing

A new AAMC study projects a shortfall of up to 139,000 physicians by 2033. Among the factors: older patients and retiring doctors.

www.aamc.org

From what I understand, residency slots are the limiting factor. There simply aren't enough. Even at the current class sizes, there are still med school graduates every year who graduate with six figure debt, but are unable to get into residency. Expanding class sizes would only make this problem worse. And as far as why they don't expand residency programs, I believe that boils down to federal $$.

And they are trying to increase the number of med school grads. There are several new osteopathic schools/branches trying to open in the next few years. Additionally, I know of at least one allopathic school that is adding a new branch. Some are also increasing class sizes.

Tl;dr politics

Please correct me if I'm wrong, though!

 

[emergentmd]

You guys will get your wish very soon. Residencies will soon proliferate given the cost benefits. Everyone will get residencies including all foreign grads.

the current class of premed:med students will struggle to find your fore fathers high paying jobs while going to places where you never could imagine living being easily replaceable by the next generation willing to make less.

Just like most other professions.

 

[Type2Fiber]

All medical students need to understand that "doctor shortage" actually means "physicians have too much leverage" in admin speak. The AAMC is a clown show with absolutely none of our best interests in mind. Increasing residency spots means our career prospects get worse, it is that simple

 

[Goro]

The United States does not have a physician shortage. It has a physician maldistribution.

Sadly, not every medical school graduate wants to practice in Nome Alaska, Kalispell Montana, Jonesboro Arkansas or Opa-locka, Florida.

 

[Angus Avagadro]

Why is it hard to get into medical school? Because Physicians and Med Schools actually believe our grads should know what they are talking about, not requiring a supervising physician. A DNP basically has a business card with a physician they can call if they have a question. See Dunning Kruger Effect. An RN, with a PhD procured from a thesis on handwashing doesn't get to call themselves Doctor when dealing with patients, IMO. Corporate medicine loves mid levels because they are cheaper to employ. As far as a shortage, there apparently is a mal distribution of physicians, which will resolve with time and the application of mid levels. In the future, you will see residency grads applying for mid level positions, because they have debt. We see this already with law school grads who can't find jobs, they are applying for paralegal positions.

 

[Goro]

In addition, it's a seller's market. They're vastly more applicants than there are seats to fill them. Quite the difference from law or Pharmacy.

 

[deleted1066189]

Wouldn't schools be better off increasing the size of their student body?

schools are already increasing class sizes, if not opening branch campuses

also, i believe only a few specialties have true shortages like FM and psych. otherwise, there is a maldistribution

 

[deleted1066189]

Might as well go to school for PA or something, less debt, graduate faster and make the same money + plus similar fulfillment.

not sure why so many people on SDN keep saying this. All you have to do is browse the PA forum website or the PA subreddit, and you'll find a fair amount of members struggling to find a job, or losing job interviews to nurse practitioners. One long-time PA (3 decades experience) even claimed the profession has an "expiration date".

Call me a naive M0, but there's a ton of equalizing NPs and PAs, when there are real differences.

 

[Goro]

So wouldn't it be foolish for someone like me (hoping to go to med school in the next 2-3 yrs) to shell out $320k for a degree when, by the time I get to be an attending, the average job will pay what mid-level salaries are today? Might as well go to school for PA or something, less debt, graduate faster and make the same money + plus similar fulfillment.

Remember that this is SDN, and the sky isn't falling. there are still more residency slots than there are bodies to fill them.

Also, some 29% of all US doctors are of the Baby Boom generation. They are, at a minimum, 55 years old. The oldest are 73ish. Split the difference and you have tons of people, like me, who are in their mid 60s. These people aren't going to live forever, much less retire at age 80. This will lead to a real doctor shortage, something that graduating some 27,000+ MDs and DOs won't be able to keep up with.

 

[toastedbutter]

not sure why so many people on SDN keep saying this. All you have to do is browse the PA forum website or the PA subreddit, and you'll find a fair amount of members struggling to find a job, or losing job interviews to nurse practitioners. One long-time PA (3 decades experience) even claimed the profession has an "expiration date".

Call me a naive M0, but there's a ton of equalizing NPs and PAs, when there are real differences.

I wasn't interested in NP vs PA that much, more MD/DO vs PA/NP. The only thing holding me back from that latter is academic medicine and research, both of which will hopefully stay vibrant in years to come.

things just get scary sometimes, especially because I am heavily concerned about my ability to pay for school. already made my peace with the fact that physician salaries will get lower and I will have to deal with the debt in other ways, but hearing about potential job loss is a different beast I do not want to deal with

 

[Angus Avagadro]

Remember that this is SDN, and the sky isn't falling. there are still more residency slots than there are bodies to fill them.

Also, some 29% of all US doctors are of the Baby Boom generation. They are, at a minimum, 55 years old. The oldest are 73ish. Split the difference and you have tons of people, like me, who are in their mid 60s. These people aren't going to live forever, much less retire at age 80. This will lead to a real doctor shortage, something that graduating some 27,000+ MDs and DOs won't be able to keep up with.

Yep, my wife is getting out, probably next year.

 

[InfectiousDiseasesH&TM]

This is a very informative thread. Many thanks to the contributing physicians for educating me (incoming freshman med student)!

I went to grad school in England -- and from what my classmates told me, most of their (UK) graduating doctors are going to Australia to practice.

Goro made an excellent point about baby boomers' forthcoming retirements. The question becomes: who will fill those roles? Will we outsource those jobs to IMGs that are able to practice, or will we gradually increase residency spots over the next decade?

You'd think the AAMC would have the lobbying power to alter the paradigm in Congress. In 2017, there were 15 physicians serving in Congress. Makes me wonder why they're not taking the lead on this.

Thanks again!

 

[mddoc]

I communicated with a med student in Europe, who grew up in the U.S., who stated that U.S. medical schools are elitist and force students to jump through unnecessary hoops in order to get in.

 

[KnightDoc]

This is a very informative thread. Many thanks to the contributing physicians for educating me (incoming freshman med student)!

I went to grad school in England -- and from what my classmates told me, most of their (UK) graduating doctors are going to Australia to practice.

Goro made an excellent point about baby boomers' forthcoming retirements. The question becomes: who will fill those roles? Will we outsource those jobs to IMGs that are able to practice, or will we gradually increase residency spots over the next decade?

You'd think the AAMC would have the lobbying power to alter the paradigm in Congress. In 2017, there were 15 physicians serving in Congress. Makes me wonder why they're not taking the lead on this.

Thanks again!

Don't be so sure that they aren't.

For every prospective med student who is worried about there not being enough spots for him or her to be accepted, there are probably 10 doctors worried about the shortage (or "maldistribution") being addressed and the market either coming into balance or being flooded as a result.

Does anyone seriously believe that the AMA or AAMC is more interested in flooding the market to meet demand, or protecting the livelihoods of those already licensed and practicing????? Law schools sure did a great job expanding capacity and addressing the great American lawyer shortage!!!

As much as we are all in it to serve humanity, with money just being a nice side benefit (as evidenced by the best and the brightest seeking to fill the greatest need rather than gravitating to the highest paying specialties ), just what would happen to @Goro's "sellers' market" if it suddenly came into balance and salaries were significantly reduced as a result??? My feeling is that medicine would look a lot like business and law, with the tippy top schools being just fine, and the rest suddenly and miraculously figuring out how to treat candidates like human beings as they struggle to fill seats.

 

[Mad Jack]

The number of physicians is controlled by the number of residency positions, not the number of medical school seats.

 

[proudofmykids]

Remember that this is SDN, and the sky isn't falling. there are still more residency slots than there are bodies to fill them.

Also, some 29% of all US doctors are of the Baby Boom generation. They are, at a minimum, 55 years old. The oldest are 73ish. Split the difference and you have tons of people, like me, who are in their mid 60s. These people aren't going to live forever, much less retire at age 80. This will lead to a real doctor shortage, something that graduating some 27,000+ MDs and DOs won't be able to keep up with.

I was going to say the same thing. The rate of retiring physicians is higherhan the rate of graduating new physicians / residency graduates.

So, how would this rectify itself? My understanding is that even with the slowing birthrate over the last decade, there will be a large deficit.

 

[Ms Procrastinator]

Why is medical school still hard to get into if the U.S. has a shortage of physicians? Wouldn't schools be better off increasing the size of their student body?

U.S. physician shortage growing

A new AAMC study projects a shortfall of up to 139,000 physicians by 2033. Among the factors: older patients and retiring doctors.

www.aamc.org

Medical school doesn't maketh the doctor, residency does. If you increase the number of med students without increasing the number of residency spots, all you're gonna get is more unemployed graduates. There's a whole lot of politics behind increasing residency spots aka it's not gonna happen anytime soon.

 

[GoPenguinsGo]

Because then we couldn't keep pointing out the fact there's a physician shortage, duuuhhhhhh

 

[LadyDustyBlue]

This is a very informative thread. Many thanks to the contributing physicians for educating me (incoming freshman med student)!

I went to grad school in England -- and from what my classmates told me, most of their (UK) graduating doctors are going to Australia to practice.

Goro made an excellent point about baby boomers' forthcoming retirements. The question becomes: who will fill those roles? Will we outsource those jobs to IMGs that are able to practice, or will we gradually increase residency spots over the next decade?

You'd think the AAMC would have the lobbying power to alter the paradigm in Congress. In 2017, there were 15 physicians serving in Congress. Makes me wonder why they're not taking the lead on this.

Thanks again!

I doubt we’d decrease residency spots over the next decade, unless you’re talking about specific specialities. But why make less? Those residency/attending spots that do exist should still be there, when current docs from the previous generations retire or meet death with a sigh of relief that they don’t have to deal with our next decade’s HC system issues. 😅

And that makes sense that newly licensed UK doctors would head to Australia. The weather is nicer and they likely will get paid well enough (hopefully!).

We forget that here in the U.S. we also lose some medical school graduates to other foreign countries too. I don’t know how big or small of a factor that is, but it’s definitely one of them.

Even as a pre-med, it’s certainly crossed my mind to move out of the country after graduation. 🤷🏻‍♀️ But I’d need a really big reason to go to medical school out of the country or to want to practice medicine elsewhere. I’m more familiar with the issues here, but somebody else who’ll likely apply the same year I do may find it appealing.

 

[Osminog]

Residency spots are limited by the government in response to passionate lobbying from physician organizations. This drives the supply of medical care down and thereby pushes physician salaries up, at the expense of many ordinary Americans who struggle to find the medical care they need. That’s why the US has the wealthiest doctors in the world while having average/mediocre healthcare outcomes when compared to other developed Western countries.

 

[Angus Avagadro]

I doubt we’d decrease residency spots over the next decade, unless you’re talking about specific specialities. But why make less? Those residency/attending spots that do exist should still be there, when current docs from the previous generations retire or meet death with a sigh of relief that they don’t have to deal with our next decade’s HC system issues. 😅

And that makes sense that newly licensed UK doctors would head to Australia. The weather is nicer and they likely will get paid well enough (hopefully!).

We forget that here in the U.S. we also lose some medical school graduates to other foreign countries too. I don’t know how big or small of a factor that is, but it’s definitely one of them.

Even as a pre-med, it’s certainly crossed my mind to move out of the country after graduation. 🤷🏻‍♀️ But I’d need a really big reason to go to medical school out of the country or to want to practice medicine elsewhere. I’m more familiar with the issues here, but somebody else who’ll likely apply the same year I do may find it appealing.

We were in Cairnes, Australia 2 yrs ago. It is the Hawaii equivalent in Australia. The local news station had a piece on local GP's. 60% of doctors in Cairnes were "Fly in Doctors", i.e. Locums. Salaries offered to recruit were 175k Australian dollars, about 150k US. They can't recruit doctors to live in paradise for that amount.

 

[wondervisions]

So wouldn't it be foolish for someone like me (hoping to go to med school in the next 2-3 yrs) to shell out $320k for a degree when, by the time I get to be an attending, the average job will pay what mid-level salaries are today? Might as well go to school for PA or something, less debt, graduate faster and make the same money + plus similar fulfillment.

I would definitely think long and hard about it.

 

[deleted1103055]

All you have to do is browse the PA forum website or the PA subreddit, and you'll find a fair amount of members struggling to find a job, or losing job interviews to nurse practitioners.

there’s been a major paradigm shift from today’s medical labor market compared to a few decades ago

Medical graduates today think in terms of trying to find an employer who will put them to work. Not too along ago physicians saw themselves as entrepreneurs. Those who susbscribe to the former continually see the sky as falling. Those in the latter group see nothing but opportunities.

 

[Faha]

Medical school will no longer be difficult to get into in the next few years. If you look back to the previous 5 years and into the next 3 years there will be ~24 new MD schools and ~24 new DO schools that have opened or will be soon be opening. by 2025 there will be ~24,000 1st year MD positions and ~11,000 1sr year DO positions. That is 35,000 1st year positions. The number of 1st time MD applicants has been in the 39,000 range for several years now and if you include applicants that apply only to DO schools the number of 1st time applicants is no greater than 44,000. An 80% chance for a MD or DO acceptance is very good odds. Basically, any applicant with a 3.0 GPA and a MCAT of 500 or higher can be accepted if they apply to many DO or MD schools. There may be slightly more than 36,000 1st year residency positions so the US and foreign IMG accepted to residency programs will be minimal in the future.

 

[LadyDustyBlue]

We were in Cairnes, Australia 2 yrs ago. It is the Hawaii equivalent in Australia. The local news station had a piece on local GP's. 60% of doctors in Cairnes were "Fly in Doctors", i.e. Locums. Salaries offered to recruit were 175k Australian dollars, about 150k US. They can't recruit doctors to live in paradise for that amount.

Interesting. But why move out of the UK to do it? And are UK doctors +/- in debt than newly graduated US docs?

And thanks for putting it in perspective for me by comparing Hawaii. I already live in San Diego, but I’d leave it for a better opportunity elsewhere. My bf is retired vet but doing reserves for another year or so, but we’re both looking into grad school/med school. We have family on the west coast, Midwest, and east coast… also in the UK. So these are questions that sometimes crosses our minds, but we genuinely want to stay in the states.

 

[InfectiousDiseasesH&TM]

Medical school will no longer be difficult to get into in the next few years. If you look back to the previous 5 years and into the next 3 years there will be ~24 new MD schools and ~24 new DO schools that have opened or will be soon be opening. by 2025 there will be ~24,000 1st year MD positions and ~11,000 1sr year DO positions. That is 35,000 1st year positions. The number of 1st time MD applicants has been in the 39,000 range for several years now and if you include applicants that apply only to DO schools the number of 1st time applicants is no greater than 44,000. An 80% chance for a MD or DO acceptance is very good odds. Basically, any applicant with a 3.0 GPA and a MCAT of 500 or higher can be accepted if they apply to many DO or MD schools. There may be slightly more than 36,000 1st year residency positions so the US and foreign IMG accepted to residency programs will be minimal in the future.

Judgment-free zone here. What I'm about to say will *trigger* some folks. For the record, I believe osteopathic physicians are equally competent and qualified to practice medicine in the United States as their MD counterparts. My best/lifelong friend is an osteopathic physician. What I'm about to ask is just an intellectual exercise.

You mentioned 24 new MD schools opening and about the same number of DO schools.

My question: Right now there are presumably thousands of DO medical students that would have chosen MD schools if they were competitive enough on paper (objective) or through other soft (subjective) metrics. Will the new MD schools attract these (what would have been D.O.) students, furthering the statistical divide between MD and DO schools? And will this statistical divide increase the MD-DO stigma? Right now, the MD-DO gap in GPA and MCAT is decent but not remarkably wide. What happens when that gap continues to increase? Will osteopaths be viewed as "less?"

And for clarification, I know that thousands of DO students may have chosen the osteopathic route because they believe wholeheartedly in those DO mission statements. My question pertains to the students who wished to go MD but settled for DO

 

[emergentmd]

There are an overabundance of medical school graduates to fill up residencies many times over. The bottleneck is the lack of residencies. That is essentially the gatekeeper to the avg college student becoming doctors.

Professional and medical lobby groups are eventually going to lose out to the Hospitals, VC, CMGs who want to remove this bottleneck. You can turn Ortho into the least competitive field in less than one year. Every middle sized city has one or two large ortho groups who can give the residents plenty of cases. These groups would love to have cheap labor that are better than PAs/NPs at half the cost who would be happy to do twice the hours of work in a more competent manner. Imagine having 4th and 5th yr ortho docs working for you doing 80 hrs a week for 60K/yr. 95% of these docs are going community anyhow and probably better trained doing 5 yrs at a community group vs trauma center where they won't see another GSW in their lifetime.

It is already coming for many fields. AMG will fill the more competitive fields, FMGs will fill everything else with many more FMGs without spots.

Every field will be affected in the next 10 yrs even with APCs in the equations.

 

[Type2Fiber]

There are an overabundance of medical school graduates to fill up residencies many times over. The bottleneck is the lack of residencies. That is essentially the gatekeeper to the avg college student becoming doctors.

Professional and medical lobby groups are eventually going to lose out to the Hospitals, VC, CMGs who want to remove this bottleneck. You can turn Ortho into the least competitive field in less than one year. Every middle sized city has one or two large ortho groups who can give the residents plenty of cases. These groups would love to have cheap labor that are better than PAs/NPs at half the cost who would be happy to do twice the hours of work in a more competent manner. Imagine having 4th and 5th yr ortho docs working for you doing 80 hrs a week for 60K/yr. 95% of these docs are going community anyhow and probably better trained doing 5 yrs at a community group vs trauma center where they won't see another GSW in their lifetime.

It is already coming for many fields. AMG will fill the more competitive fields, FMGs will fill everything else with many more FMGs without spots.

Every field will be affected in the next 10 yrs even with APCs in the equations.

this is the problem. the only people who will lose due to rapid expansion of residencies are current residents and students

 

[mddoc]

Don't be so sure that they aren't.

For every prospective med student who is worried about there not being enough spots for him or her to be accepted, there are probably 10 doctors worried about the shortage (or "maldistribution") being addressed and the market either coming into balance or being flooded as a result.

Does anyone seriously believe that the AMA or AAMC is more interested in flooding the market to meet demand, or protecting the livelihoods of those already licensed and practicing????? Law schools sure did a great job expanding capacity and addressing the great American lawyer shortage!!!

As much as we are all in it to serve humanity, with money just being a nice side benefit (as evidenced by the best and the brightest seeking to fill the greatest need rather than gravitating to the highest paying specialties ), just what would happen to @Goro's "sellers' market" if it suddenly came into balance and salaries were significantly reduced as a result??? My feeling is that medicine would look a lot like business and law, with the tippy top schools being just fine, and the rest suddenly and miraculously figuring out how to treat candidates like human beings as they struggle to fill seats.

We have a person in this thread, as well as many other doctors, who are leaving because of burnout. We need more doctors on the ground, it only makes sense to do that. Yes you make more money, but you also feel like you don't have a life and begin to question yourself. Is that the price that has to be paid?

 

[Mad Jack]

there’s been a major paradigm shift from today’s medical labor market compared to a few decades ago

Medical graduates today think in terms of trying to find an employer who will put them to work. Not too along ago physicians saw themselves as entrepreneurs. Those who susbscribe to the former continually see the sky as falling. Those in the latter group see nothing but opportunities.

Why work for an employer when I can be the one employing all of these doctors that have no entrepreneurial spirit

 

[Ms Procrastinator]

Interesting. But why move out of the UK to do it? And are UK doctors +/- in debt than newly graduated US docs?

And thanks for putting it in perspective for me by comparing Hawaii. I already live in San Diego, but I’d leave it for a better opportunity elsewhere. My bf is retired vet but doing reserves for another year or so, but we’re both looking into grad school/med school. We have family on the west coast, Midwest, and east coast… also in the UK. So these are questions that sometimes crosses our minds, but we genuinely want to stay in the states.

Someone I knew went to work in the UK only to see people filling out job apps for positions in New Zealand (or Australia I always group them together).

Spoiler: She was real confused

She thinks the job she has in the UK is way better than the one she had back home for a variety of reasons. The docs in the UK think other places like New Zealand offer better jobs, docs in New Zealand and Australia think other places offer better jobs, and the beat goes on and on.

Doctors in the UK aren't more in debt than doctors in the US. They do get paid worse. Junior doctors graduate with around £80,000 and usually earn 3x less than US docs. The pandemic put a strain on them and a lot stated that they disliked how the government handled it and would like more pay. They were working insane hours before and were now working even more. There's also this whole political thing about the NHS and privatization.

 

[Goro]

Judgment-free zone here. What I'm about to say will *trigger* some folks. For the record, I believe osteopathic physicians are equally competent and qualified to practice medicine in the United States as their MD counterparts. My best/lifelong friend is an osteopathic physician. What I'm about to ask is just an intellectual exercise.

You mentioned 24 new MD schools opening and about the same number of DO schools.

My question: Right now there are presumably thousands of DO medical students that would have chosen MD schools if they were competitive enough on paper (objective) or through other soft (subjective) metrics. Will the new MD schools attract these (what would have been D.O.) students, furthering the statistical divide between MD and DO schools? And will this statistical divide increase the MD-DO stigma? Right now, the MD-DO gap in GPA and MCAT is decent but not remarkably wide. What happens when that gap continues to increase? Will osteopaths be viewed as "less?"

And for clarification, I know that thousands of DO students may have chosen the osteopathic route because they believe wholeheartedly in those DO mission statements. My question pertains to the students who wished to go MD but settled for DO

Just to clarify Faha's comments, since 2011, some 27 MD schools have opened, and about 20-23 DO schools. It's not just within the past few years.

That's enough trying to hijack the thread into a DO vs MD flame war.

 

[mmchick]

I wasn't interested in NP vs PA that much, more MD/DO vs PA/NP. The only thing holding me back from that latter is academic medicine and research, both of which will hopefully stay vibrant in years to come.

things just get scary sometimes, especially because I am heavily concerned about my ability to pay for school. already made my peace with the fact that physician salaries will get lower and I will have to deal with the debt in other ways, but hearing about potential job loss is a different beast I do not want to deal with

I think this is a very cynical POV. There are plenty of ways to pay off your debt, even in more low-paying positions or specialties. In fact, a lot of the areas you are likely to have great job security via addressing this issue of maldistribution are in the rural areas that are offering national debt repayment programs which is additional loan repayment on top of a perhaps "subpar" income (still completely adequate however at 6 figures).

The people who complain about lack of job security are the same people who want to live in high rise penthouse suites in NYC overlooking Central Square while working 9-5 M-W as a pediatric neurosurgeon who only excises frontal lobe lesions that are shaped like hearts. I mean, the residency spots not getting filled every year are plenty in FM/IM and those are the specialties that qualify you for repayment programs attending to areas with physician shortages.

The sky is not falling. You will be okay.

 

[Angus Avagadro]

Interesting. But why move out of the UK to do it? And are UK doctors +/- in debt than newly graduated US docs?

And thanks for putting it in perspective for me by comparing Hawaii. I already live in San Diego, but I’d leave it for a better opportunity elsewhere. My bf is retired vet but doing reserves for another year or so, but we’re both looking into grad school/med school. We have family on the west coast, Midwest, and east coast… also in the UK. So these are questions that sometimes crosses our minds, but we genuinely want to stay in the states.

Remember, in the UK, they have a finite number of Consultants/Attending. You basically have to wait for death, or retirement to fill one of these positions. You could end up being Registrar/ Resident for years waiting for a Consultant spot. This was explained to me years ago by one of our fellows, but I don't think much has changed with the NHS. I assume,(I know that's dangerous), they don't want to wait to be an attending and are willing to go to Australia, which might not be such a bad gig. I really liked Australia and the Aussies.

 

[YCAGA]

ah. cute. military medicine it is

The same military that uses CRNA’s instead of anesthesiologists in their most front line units? Good luck with that buddy

 

[tellme_areyoufree]

Why is medical school still hard to get into if the U.S. has a shortage of physicians? Wouldn't schools be better off increasing the size of their student body?

U.S. physician shortage growing

A new AAMC study projects a shortfall of up to 139,000 physicians by 2033. Among the factors: older patients and retiring doctors.

www.aamc.org

We don't have a shortage so much as a maldistriburion.

 

[Lucca]

I don’t like maldistribution as a term either because it implies there is some central logic to how physicians are distributed, which there is not. Healthcare labor marketplace is a free market with the exception of residency match process. Physicians have *self-distributed* themselves mostly among the major metropolitan areas of the country. In spite of there being a ton of financial incentives to go to highly underserved or rural areas, none of those incentives have worked to enough of an extent to really change the distribution of physicians. I suppose things are changing somewhat now that mid sized cities are becoming larger and more desirable but a vast swath of this country still has very few physicians.

More med schools without more residency slots won’t change this, but as labor supply increases there will be an increasing portion of the labor market that will have to search outside of the major metro areas for a job. For most specialties, guild behavior helps keep supply low and leverage high with the notable exceptions of a few specialties like EM/RadOnC that quickly face a kind of market discipline in the form of facing a contraction of med student interest/application following evidence of oversupply and likely cutting residency spots after a period of expansion. For primary care demand is so high the supply probably couldn’t go high enough compared to where it is now but there is low interest unfortunately in USMDs going into primary care.

 

[MidnightOil14]

Why is medical school still hard to get into if the U.S. has a shortage of physicians? Wouldn't schools be better off increasing the size of their student body?

U.S. physician shortage growing

A new AAMC study projects a shortfall of up to 139,000 physicians by 2033. Among the factors: older patients and retiring doctors.

www.aamc.org

Look what happened to Pharmacy after 20 years...

 

[deleted927028]

IMHO, getting into Med school seems harder only because we don’t have single window selection for Med schools. If we had it, the acceptance rate will be above 40% which is not too bad. But since we are forcing the students to individual colleges, the number of applicants get inflated artificially which brings the acceptance to around 5% (if we exclude instate bios in public universities). If we use only objective measures as selection criteria, request only one common application and let students to pick a school based on predetermined ranking, it will become easier and less stressful for everyone. Which is how it is done in most of the countries.

 

[BruceWaynMD]

Hello, I’m a graduating M4 in the US. I was so happy to get into med school as a non-trad and pass all my classes and pass step 1 and step 2 just to not match into peds back in March. Soaped a TY A lot of medical schools not enough residency spots. There is no physician shortage. I’m not sure of the reason for this set up but I think it has to be sinister. Best of luck

 

[Temporal_weapon]

This question is asked a few times a year, and each time I come back to see what kind of trends are taking place in the body of answers.

I've read everything in this thread, and I fear the trend lines are drawing towards something more sinister. In addition to the points of contentions listed here (lack of residency slots, maldistribution, mid-level encroachment and employer favorability towards NPs/PAs), there's something else that's been weighing on my mind about the physician "shortage" (or perceived shortage) and a few changes I've noticed.

First, there was the "Theranos" debacle. I was fairly certain this signaled a new age about the potential of automating the medical decision-making process. After the enterprise failed, I was relieved, but worried about automation's future relationship with medicine. What the "CEO" managed to do was bring attention to the diagnostic process, frame it as an inefficiency, and introduced it to the conversation of silicon valley and wall-street.

Recent news states there's a "nonprofit" medical school installed in Arkansas by a Wal-Mart "heiress". For those unfamiliar with the retail history of walmart, they started out as a humble retailer before it became something that destroyed the individualized, humanistic and open-market nature of retail and commerce. This new walmart medical school boasts a "holistic" approach, which tells me they know nothing of what they're talking about.

Walmart completely ruined retail, but this didn't take place in a decade. They began in the 1960s and quietly crept to the status it has today. Wal-mart employed predatory practices that pretty much broke with every convention of sales. They'll open up express stores in small towns to wipe out all mom-and-pop stores. They disrupted artisanal practices. Everything from grocery stores/farmers' markets, gyms, etc. to less "prominent" companies, like Target. They operate their stores on a skeleton staff and pay them pocket change. Then they will remove the express stores and root themselves in more affluent parts of town, essentially leaving people in rural areas an hour away from essentials. If this pattern was applied to medicine, it could be potentially disastrous.

There's still a lot of money concentrated into the hands of people who practice medicine, I'm certain corporations have been trying to make the squeeze. I have no idea how upper-level management decisions are made, but I do feel as though medicine is becoming increasingly compartmentalized and corporatized. The fact that venture capitalists, such as the Walton family, have posited the idea of a medical school makes me very nervous, personally.

All of these moderate, big-picture changes should signal implications that the next generation of doctors should do what it takes to prevent medicine from becoming "walmartized".

 

[mmchick]

Hello, I’m a graduating M4 in the US. I was so happy to get into med school as a non-trad and pass all my classes and pass step 1 and step 2 just to not match into peds back in March. Soaped a TY A lot of medical schools not enough residency spots. There is no physician shortage. I’m not sure of the reason for this set up but I think it has to be sinister. Best of luck

Well I think there's a lot more to this story than what just meets the eye. What were your Step scores? How were your mentor relationships and clerkship grades? Who wrote your LORs and how developed were your relationships with those people? How many programs did you apply to and interview for?

I think what's sinister are the people coming on here acting like the sky is falling and that medical graduates are going to overwhelmingly not be able to land a residency spot. The data just simply does not support that. The 2021 match rate for all USMD seniors was roughly 94%. That is a great number. In fact, the number of residency spots available per senior was 1.77 which was at it's highest in the last 40 years this last round. Also, there were something like 200 SOAP positions unfilled.. source

There's always going to be cynical people wherever you go. Some people insist on seeing the worst in things despite reality being otherwise. If you're a frightened pre-med or medical student, do your own research. People will continue to unfortunately be sick and die everyday, there will never be a time where society cannot use a competent doctor.

 

[Select All That Apply]

@Temporal_weapon Theranos and Walmart have nothing to do with the limitation of residency positions within the United States. Just want to nip this in the bud before someone attempts to humor you with mental gymnastics that would give me a migraine.

 

[Temporal_weapon]

@Temporal_weapon Theranos and Walmart have nothing to do with the limitation of residency positions within the United States. Just want to nip this in the bud before someone attempts to humor you with mental gymnastics that would give me a migraine.

Well, I'm still pretty concerned about the corporatization of medicine, and how this can tie into the decisions around residency openings. I know my previous post was a bit of an offshoot, but I hope it parses.

 

[deleted917484]

Residency spots are limited by the government in response to passionate lobbying from physician organizations. This drives the supply of medical care down and thereby pushes physician salaries up, at the expense of many ordinary Americans who struggle to find the medical care they need. That’s why the US has the wealthiest doctors in the world while having average/mediocre healthcare outcomes when compared to other developed Western countries.

This. It’s very much by design of opposing parties.

 

[C Smith]

I have been reading about the shortages with Physicians, and Nurses. The thing is that the shortages are for the jobs/specialties that nobody wants in the places that nobody wants to live/work (usually for less money). These shortages are always going to exist.

 

[BruceWaynMD]

Well I think there's a lot more to this story than what just meets the eye. What were your Step scores? How were your mentor relationships and clerkship grades? Who wrote your LORs and how developed were your relationships with those people? How many programs did you apply to and interview for?

I think what's sinister are the people coming on here acting like the sky is falling and that medical graduates are going to overwhelmingly not be able to land a residency spot. The data just simply does not support that. The 2021 match rate for all USMD seniors was roughly 94%. That is a great number. In fact, the number of residency spots available per senior was 1.77 which was at it's highest in the last 40 years this last round. Also, there were something like 200 SOAP positions unfilled.. source

There's always going to be cynical people wherever you go. Some people insist on seeing the worst in things despite reality being otherwise. If you're a frightened pre-med or medical student, do your own research. People will continue to unfortunately be sick and die everyday, there will never be a time where society cannot use a competent doctor.

Yes, so still some USMDs went unmatched.

Well I think there's a lot more to this story than what just meets the eye. What were your Step scores? How were your mentor relationships and clerkship grades? Who wrote your LORs and how developed were your relationships with those people? How many programs did you apply to and interview for?

I think what's sinister are the people coming on here acting like the sky is falling and that medical graduates are going to overwhelmingly not be able to land a residency spot. The data just simply does not support that. The 2021 match rate for all USMD seniors was roughly 94%. That is a great number. In fact, the number of residency spots available per senior was 1.77 which was at it's highest in the last 40 years this last round. Also, there were something like 200 SOAP positions unfilled.. source

There's always going to be cynical people wherever you go. Some people insist on seeing the worst in things despite reality being otherwise. If you're a frightened pre-med or medical student, do your own research. People will continue to unfortunately be sick and die everyday, there will never be a time where society cannot use a competent doctor.

I’m not going to argue about it. Still USMDs went unmatched regardless. Some USMDs like me had to SOAP. At least 30 students in my class had to. The data doesn’t tell the whole story. Just like telling you my numbers etc won’t give you the complete picture of me. Either way it’s not going to stop me from being a good doctor. There are patients who look like me that need me and I do it for them.👩🏽‍⚕️regardless of a unfair system.