Will it become easier or more difficult to get into med school in the future?

[chenzt]

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There will be a shortage of residency spots because the AAMC has asked (and is still asking) US schools to ramp up their enrollment. I don't see the AAMC asking med schools to slow it down. This is what's under his control here. It's pretty disingenuous to say "just create more residencies" (After 8 years of accelerated matriculation you instigated) when you are the reason people aren't going to match in the first place.

It's much easier for AAMC to influence medical schools than to influence congress. Ramping up enrollment could be a strategy to make the issue more pressing and force congress's hand.

 

[Arkangeloid]

As long as MD AMGs in the 2017 match are fine (2018 if I take a research year), I'm fine with whatever happens. I do worry about my little brother in a BA/MD program, though. Hopefully things won't be too competitive (in terms of getting the specialty you want) in the early 2020s.

The way I see it, IMGs and DOs will get crowded out of the match first, and AMG MDs will fill the lower tier IM, FM, and Peds slots that would have gone to the IMGs and DOs. So the AMG MDs should be fine for a little while longer.

My main concern is that the increased amount of AMGs will increase the competitiveness of the specialties that are more competitive but not quite at the top, such as EM, GenSurg, Anes, etc, but I don't think AMGs will have trouble matching into A specialty for a while.

 

[chenzt]

The AAMC in the US should seriously see what will happen if they keep up pumping AMG's with 200,000 USD in school debt without expanding residency slots. I can't imagine the chaos it will cause when 20% of AMG's with crushing debt can't do a residency and can't default on their loans for the next 20 years.

Hopefully congress will act before then. But I have my doubts.

 

[Law2Doc]

It's much easier for AAMC to influence medical schools than to influence congress. Ramping up enrollment could be a strategy to make the issue more pressing and force congress's hand.

If this was all over a span of just a few years maybe that could mke sense. But they started this ramping up around 2005. They didnt ask congress to do anything bout it until recently. It's a stretch to say they were doing that with the plan of forcing Congress hand. They were more likely hoping they didn't force congresses hand before they reached monopoly status.

 

[Law2Doc]

Hopefully congress will act before then. But I have my doubts.

They won't -- we are talking about a lot of money. But our market system adjusts for this better than some other countries. When law school grads stopped getting jobs, the number of people applying to law school dropped (not totally because there are other things you can do with a law degree, but somewhat). So too when medical students stop getting residencies, the number of applicants will drop. There will be a few bad years for people who didn't sense the trend, but the market should right itself even without congressional action.

 

[GypsyHummus]

What is so bad about maximizing the number of students per residency slots/1:1 for US med grads? The only negative I see is squeezing out foreign grads, and if everyone is getting a residency, then there should be no problem. I think a lot of the students would end up in less desirable places, but at least they would have a residency.

And now that the MD and DO residencies are merging, there will be a maximum use of the slots. Do un-used slots cost money?

 

[GypsyHummus]

They won't -- we are talking about a lot of money. But our market system adjusts for this better than some other countries. When law school grads stopped getting jobs, the number of people applying to law school dropped (not totally because there are other things you can do with a law degree, but somewhat). So too when medical students stop getting residencies, the number of applicants will drop. There will be a few bad years for people who didn't sense the trend, but the market should right itself even without congressional action.

When do you forsee these trend? Do you really think that medical schools will go the way of law schools?

 

[Law2Doc]

When do you forsee these trend? Do you really think that medical schools will go the way of law schools?

Medicine is different than law in that law schools are the true gatekeepers of the profession -- the number of law students directly results in the number of lawyers, while in medicine the number of residency slots, not students, reflects how many people become doctors, regardless of how many people are in US med schools. So it's a slightly different analysis, and a longer lag in reaction time. Also law is more closely tied to the economy -- in a better economy we actually need more lawyers because more deals are being done, more leases and mortages signed, more money is moving around, more investments are made, more estate planning, while in medicine as people live longer and the population grows, the demand never really drops, even in bad times. I foresee the AAMC keeping their foot on the gas and increasing enrollment until US med school slots approximate US residency slots. (As an aside, I don't see Congress throwing tens of millions into the system to create a big increase in residency slots at the same time the consensus is that healthcare in the US is too expensive -- cheaper NPs and PAs to fill the shortfall of physicans will be the more likely focus under the current governmental and public mindset.)

As soon as it's not regarded as "guaranteed" that someone who graduates from US med school will land a residency which leads to a six digit income physicians job, you will see med school applications drop off. There will be a lag, so some year(s) will fall into the trap, but for the most part the market will adjust over a short couple of years. This will all start happening as soon as the number if US grads starts to reach that 1:1 ratio with residency slots.

 

[Dave89]

The number of med students has nothing to do with the number of doctors. The number of residencies governs this and AAMC has nothing to do with that. The AAMC wanted to increase the number of US med students to start approximating the number of residency slots. The whole point of increasing US med students was really to drive offshore programs out of the picture not increase the number of doctors. But the number of doctors will stay constant even if the AAMC were to recommend and implement a 30000% increase. The ACA isn't going to lead to more residencies -- there is no money for this.

I'm curious about this - what happens to the 4th years who don't match - do they go and work as a retail store manager or something?

Also, aren't there always unfilled IM, peds residency spots?

Getting through State U with a 3.4/28 (DO) or a 3.7/31 MCAT (MD) is a lot easier than getting into an Ivy league school and/or having parents who made partner at an ibanking firm.

Not all of those who opt to go to a state school necessarily got a 31 on their MCAT. It's usually a decision based on financial considerations. Just want to put this out there.

Going to a private school and paying ~20,000 a year is injudicious IMO, unless someone other than you is footing the bill.

 

[angryamygdala]

Interesting, I have heard talk from the dean of Medicine at the school I attend, as well as some other NY medical schools about a reversion to WWII style medical education. That is, a two year program leading to an MD in order to more efficiently move students through the system. This is more similar to how Europe works, and would probably help boost enrollment. But of course for those of us already here, it would feel like our degree's are being cheapened.

 

[HomerWells]

Yeah, but why? Why does it matter if the people completing residencies here are staying and working as physicians? It would be one thing if IMGs were completing residencies here and then moving away, but that really isn't the case.

One good reason is to discourage fraud and abuse. The percentage of foreign trained doctors practicing in an area correlates with patient per capita medicare expenditures.

 

[kavorca]

I'm curious about this - what happens to the 4th years who don't match - do they go and work as a retail store manager or something?

Also, aren't there always unfilled IM, peds residency

It is less and less every year.

 

[Law2Doc]

Interesting, I have heard talk from the dean of Medicine at the school I attend, as well as some other NY medical schools about a reversion to WWII style medical education. That is, a two year program leading to an MD in order to more efficiently move students through the system. This is more similar to how Europe works, and would probably help boost enrollment. But of course for those of us already here, it would feel like our degree's are being cheapened.

Not going to happen. First, as this thread is discussing, getting more US med students through faster is counter-productive if there aren't residency slots at the other end. All it does is guaranty that the folks with abbreviated degrees end up with no jobs. Second, Schools are struggling to fit the LCME mandated curriculum into the allotted time as is. There was a time, several decades back, when individuals with PhDs in related fields could get an MD in two years, but the LCME decided this was a bad idea and closed them down. Unlikely it's going to go back on that decision without some more drastic new need.

 

[Law2Doc]

I'm curious about this - what happens to the 4th years who don't match - do they go and work as a retail store manager or something?

Also, aren't there always unfilled IM, peds residency spots?

Not all of those who opt to go to a state school necessarily got a 31 on their MCAT. It's usually a decision based on financial considerations. Just want to put this out there.

Going to a private school and paying ~20,000 a year is injudicious IMO, unless someone other than you is footing the bill.

4th years who don't match either find something in SOAP or find a productive way to spend the year and reapply. At this point in time it is rare for a US grad not to find something. As for unfilled spots, there is a mechanism called SOAP (a more organized successor to the scramble) for people who didn't land spots in the match to have another shot. After SOAP, programs will fill the remaining unfilled spots, if any, based on people who call/email at opportune times. There are always thousands of international/foreign med school grads applying who don't get spots, so nothing goes "unfilled". As mentioned, as the number of US grads increases each year, and ultimately will reach the number of residency slots in a handful of years at the current pace, there becomes the potential that a decent percentage of US grads won't find anything, even after SOAP, even if we assume they get picked over the IMG/FMG crowd.

 

[TheWeeIceMan]

They won't -- we are talking about a lot of money. But our market system adjusts for this better than some other countries. When law school grads stopped getting jobs, the number of people applying to law school dropped (not totally because there are other things you can do with a law degree, but somewhat). So too when medical students stop getting residencies, the number of applicants will drop. There will be a few bad years for people who didn't sense the trend, but the market should right itself even without congressional action.

The number of people applying to law school dropped, but did the number who enroll each year drop as well? It was my impression that law schools just dropped their typical admissions standards to keep their classes full, which doesn't exactly fix the problem of oversupply. My fear is that this will happen to medical schools (though much farther down the line). Instead of cutting class sizes due to decreased applicants, schools will simply take less qualified individuals and the supply of those applying to residency will not change.

 

[yehhhboiii]

I cant imagine how bad it would feel to go through all the bs of getting into med school, finishing and applying to residency with nothing to show for it

 

[Law2Doc]

The number of people applying to law school dropped, but did the number who enroll each year drop as well? It was my impression that law schools just dropped their typical admissions standards to keep their classes full, which doesn't exactly fix the problem of oversupply. My fear is that this will happen to medical schools (though much farther down the line). Instead of cutting class sizes due to decreased applicants, schools will simply take less qualified individuals and the supply of those applying to residency will not change.

Enrollment went down too, but not as much as some would have liked. I actually don't think admissions standards really changed all that much -- there were always law schools who would take people with C's. But again, law is different in his respect because there are numerous avenues in which you can use a law degree besides being a lawyer -- not so with med school. And you can get licensed after passing the bar, you don't need to land a year of residency to gelip to the business. So the guy who realizes the chances of actually becoming a lawyer are slim might still go to law school, figuring he can always get his license and open his own shop, or just use the degree in business or consulting. But the guy who realizes there aren't enough physician jobs And not land a residency is less likely to apply in the first place.