Number of residents rising in U.S. hospitals

There were 0.6% more resident physicians last year, despite a federal push to slow spending in graduate medical education.

By Jay Greene, amednews staff. Oct. 2, 2000.

Despite a federal reimbursement payment cap, the number of resident physicians increased by 0.6%, or 606, to 97,989 in the 1999-2000 academic year, according to a survey in the Sept. 6 Journal of the American Medical Association. The increase primarily was driven by a 5.2% increase in osteopathic residents.

"We find no evidence that the Balanced Budget Act of 1997 has had its intended effect of slowing the growth of GME," wrote the JAMA authors. "Although the number of residents with federal reimbursement has been restricted and federal support for the indirect costs of GME has decreased, the number of physicians in training continues to increase."

Since 1997-98, first-year residency positions have increased 4%to 25,498 in 1999-2000 from 24,516.

Minority residents also appear to be increasing. For the second year, the number of first-year white residents declined (2.0%) while the number of first-year Hispanic residents increased 10.5%. Asian residents increased 11%, but African-American residents decreased 7.1%.

The total number of residency programs has increased 5.8% since 1994-1995. The increase has been driven by a 12.7% increase in subspecialty programs the past five years, averaging 83 more subspecialty programs per year.

In the past six years, U.S.-trained residents in primary care have increased 23.9% while the number of international medical graduates in those programs has declined by 12.3%, the report said. In primary care, residents in family practice spend the most time (37.7%) in community ambulatory settings while those in pediatrics spend the most time (46.6%) in hospital outpatient settings.

But time in managed care settings has decreased during the past three years for all primary care specialties. One reason for the decline is that there are fewer staff-model HMOs.

Of 7,946 residency programs accredited by the Accreditation Council for Graduate Medical Education, 95%, or 7,560, responded to the AMA's Annual Survey of Graduate Medical Education Programs.