Medicine is unique compare to other fields like law, nursing, pharmacy, etc. There is still a bottleneck to prevent oversaturation of physicians ... residency. All states require at least 1 year of residency to obtain an unrestricted license ... others require more (and some states require DOs to do an AOA approved intern year). A lot of states require IMGs to do at least 3 years of residency to obtain unrestricted licenses.
The question is - because of the bottleneck, will non-physicians try to bypass physicians (ie increase midlevels, expanded privileges for pharmacy/DPTs etc)?
And medicine is a very wide field - there are some areas of medicine where there is a shortage of physicians, other areas where there is saturation of physicians, and other areas of medicine where this is a maldistribution of physicians. And nothing is ever static - things change (albeit slowly). What is saturated now can become a shortage field in the future, and vice versa.
As long as there are thousands of unfilled residency positions each year, there is still room for more medical students.
Sure, not everybody will get the Plastics residency at the big-city academic center that they dreamed of when they were kids.
Tough break.
That being said, there is no all-encompassing "physician shortage". There is a shortage of primary care physicians in rural areas.
In rural areas, there are shortages of everyone - from specialists to primary care. In urban areas, primary care are in demand, but so are some specialities which happen to be in short supply nationwide. Hence why it's important to do specific research about your specific field, and not just do a generic search.
The number of unfilled spots is getting fewer and fewer every year. Last year, there were less than a thousand unfilled spots through the match.
From the 2013 NRMP residency Match (data from NRMP 2013 Match Data)
Total number of PGY1 spots available through NRMP (including transitional year, preliminary medicine, preliminary surgery) - 26,392
Total number of matches for PGY1 spots through NRMP - 25,463
Number of unfilled spots through NRMP - 929
Total number of unique applicants for PGY1 spots through NRMP - 40,335 (25,463 matches, 8,892 unmatched, 2814 withdrew, and 3166 submitted no rank list)
Breakdown of applicants (to PGY1 spots only, those who match PGY2 but not PGY1 counts as unmatched for this purpose)
Seniors of US MD School - 17,856 (16,390 matched, the rest went unmatched, withdrew, or submitted no rank list)
Previous graduates of US MD School - 1,768 (1487 matched, the rest went unmatched, withdrew, or submitted no rank list)
Students/Graduates of DO School - 3627 (2019 matched, the rest went unmatched, withdrew, or submitted no rank list)
Students/Graduates of Canadian Medical School - 34 (14 matched, the rest is same as above)
US Citizens Students/Graduates of International Medical School - 6882 (2706 match, the rest is same as above)
Non-US Citizen Students/Graduates of International Medical School - 10,133 (3601 matched, the rest is same as above)
In 2012, there were 22,934 matches for PGY1, and in 2010, there were 21,749 matches. 2013 had 25,463.
From what I gather on SDN, residency placement depends on
board scores,
clinical grades,
LOR's,
audition rotations, And people always say how you do on the boards depends on "you!" and not the school. So lets say a top student 30 mcat 3.6 sgpa, that could have went to KCOM, went to ACOM, Marian, wherever, if this student studies long and hard, he'll probably do well on the boards. LOR's, clinical grades, and audition rotations all depend on how good your people skills are.
Since I am an interviewer for a residency program as well as a fellowship program, and participate in the ranking meetings for both programs, let me give you my perspective (and it's only my perspective)
board score - important (failure or barely pass, decreasing trends, or scores not consistent with academic records - raises eyebrows)
clinical grades - somewhat important. Interested in how you performed in various rotations, the more honors or high pass, the better. I look at the histogram from the MSPE as well as overall class rank, along with board score, to give me a sense of your "academic" prowess.
LORs - unless it is a well-known name in the field, or from someone I know personally - I just check to make sure there is nothing unusual from the LOR. Almost everyone's LORs is strong and excellent so a lack-luster LOR will sink you, while a glowing LOR won't necessarily help unless you have it from someone well-known in the field (or from someone I know) - and a lackluster letter from someone famous can also sink you too.
Audition rotations - if it is at my place, then in addition to LORs, I try to get input from the faculty and residents that you've worked with. If it is at another place, I try to see how you did, rotating at a different hospital. Since I know 3rd/4th year DO clinical rotations are highly variable, I focus on the type of rotations you did as a 3rd/4th year (probably more so than the other interviewers who are not DOs). I want to know you've rotated at a major university teaching hospital, worked well on a team, and thrived in that environment. I don't want your first inpatient experience to be as an intern on wards.
Interviews - to make sure you are a normal person. It's also an opportunity for you to explain any red flags or concerns. I look at your personal statement and extracurricular activities (and prior work experience) to get a sense of who you are, and to start the conversation. Not interested in testing medical knowledge. It's more to see if you are "normal" that I can work with, the residents can work with, and the faculty can work with.
It's extremely rare for someone to interview so well that it bumps them up a few spot on the rank list. More likely the interview has minimal impact. Sometimes the redflags cannot be overcome and the committee decides to not rank, despite a good interview. A few occasions, the committee have decided not to rank someone due to poor interview performances (usually it's a consensus from the committee, so it's not just one interviewer having a grumpy day).
The "residency crunch" has been felt for the past few years, as there have been more applicants to our programs every year ... and we are getting pressure from admin to prioritize US MDs over DOs and IMGs. (when it comes to who to interview, and making the rank list)
