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American Medical News

American Medical News

 
PROFESSION

Medical schools increase enrollment to meet future demand

But physician shortage fears remain.

By Myrle Croasdale, amednews staff. May 15, 2006.

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Consensus is growing that a physician shortage lies in the near future, though questions remain over how large it will be and how to best address it. Medical educators are taking shortage predictions seriously and are ramping up class sizes.

Edward Salsberg, director of the Assn. of American Medical Colleges Center for Workforce Studies, said, "We really need to see this increase in U.S. production now in order to be prepared for the likely future demand for services."

Final data from a 2005 survey by the AAMC Center for Workforce Studies show that allopathic medical schools plan to add 1,400 to 2,000 first-year medical students by 2015-16, a 9% to 12% increase over the entering class in 2002-03. Add in osteopathic expansion of 2,000 to 2,500 more students, and a total of 3,400 to 4,500 additional first-year medical students could be in the 2015-16 pipeline.

According to the AAMC, 65 allopathic schools have increased enrollment since 2000, or have plans to do so. Allopathic schools in states that have experienced rapid population growth are the most likely to expand, particularly in the South and West. Also, the majority of increases appear to be coming from public institutions and at community-based schools rather than research-intensive programs. Eleven schools reported they would focus on increasing minority enrollment and enrollment of those wanting to practice in underserved areas. The AAMC anticipates that five new allopathic schools out of a possible 15 under consideration will likely come to fruition between 2007-08 and 2015-16.

However, those increases may not be enough to meet patient demand. The United States would need roughly 10,000 to 15,000 more first-year students by 2015-16 than it had in 2002-03, if a target of 85,000 new physicians were added to the work force by 2020, according to the AAMC.

If a 30% jump in allopathic enrollment were seen, the AAMC said this would mean an additional 33,000 MDs by 2020, or 55,000 more physicians when including new osteopaths.

This starts to fill the gap if one is expecting a shortage of 85,000 physicians but misses the mark when considering some experts' predictions of a need for 200,000 more physicians.

"We have to increase the number of first-year [resident] positions by 10,000 as soon as we can," said Richard Cooper, MD, professor of medicine and senior fellow at the University of Pennsylvania's Leonard Davis Institute of Health Economics, Philadelphia. "Every year we delay we fall behind."

The AMA supports the idea that there are current physician shortages in some geographic regions and medical specialties.

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 ADDITIONAL INFORMATION: 

The physician pipeline

Work-force experts project a shortage of 85,000 to 200,000 physicians by 2020. Here's a look at how many more first-year medical students are expected versus what experts say the need will be.

First-year medical students
(2002-03)
19,567
Estimated class size based on expansion plans at existing schools and new schools under consideration22,912-23,997
(17%-23% increase)
Estimated class size needed by
2015-16 to fill shortage
29,351-34,242
(50%-75% increase)

Sources: Assn. of American Medical Colleges Center for Workforce Studies, Council on Graduate Medical Education, and original reporting by Myrle Croasdale, amednews staff

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Residency positions key

Without more residency positions, physician supply won't increase. Richard Cooper, MD, professor of medicine at the University of Pennsylvania's Leonard Davis Institute of Health Economics, suggests that even by adding 1,000 more first-year residency positions (PGY-1) annually starting in 2010, physician supply won't come near to matching demand by 2025.

Physicians per 100,000 population
Change in
PGY-1/year in 2010
PGY-1DemandNone+500+1000Demand
19832012112003274274274280
19842062142004275275275283
19852122172005275275275287
19862162202006276276276291
19872202232007276276276295
19882252272008277277277299
19892282302009277277277303
19902312332010277277277307
19912352362011277277277311
19922382402012277277277315
19932412432013277277278319
19942452472014277278278323
19952492502015276278279328
19962522542016276278280332
19972562572017276279282336
19982602612018275279283340
19992642652019275280285344
20002682682020274281287344
20012712722021274282290348
20022722762022273283292352
2023273284295356
2024272285298361
2025272286301365

Source: Richard Cooper, MD, April presentation

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Copyright 2006 American Medical Association. All rights reserved.
 
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