Med School Enrollment Expands, Concern for Residency Slots Lingers

Megan Brooks

Disclosures

July 25, 2019

Enrollment in US medical schools has grown by 31% since 2002, and, coupled with increases in enrollment at DO-granting schools, overall medical student enrollment is now 52% higher than in 2002, according to the latest data from the Association of American Medical Colleges (AAMC) released today.

But concern remains high about the availability of graduate medical education (GME) opportunities at the state and national levels.

"US medical schools have responded to the AAMC's call to action by significantly expanding enrollment," AAMC Executive Vice President Atul Grover, MD, PhD, said in a statement.

"Now the national focus must shift to increasing the number of residency training slots so the nation will have enough physicians to combat the impending shortage and care for our growing and aging population," said Grover.

Expansion Goal Achieved, but Ongoing Concern

In 2006, owing to concerns of a likely physician shortage, the AAMC called for a 30% increase in first-year medical student enrollment by the 2015–2016 academic year (over 2002–2003 levels).

Using the baseline of the 2002–2003 first-year enrollment of 16,488 students, a 30% increase corresponds to an increase of 4946 students for a total of 21,434. That goal was surpassed in 2018–2019, with first-year matriculation reaching 21,622 students, according to the 2018 Medical School Enrollment Survey, AAMC's annual survey of US medical school deans.

First-year matriculation at DO-granting schools in 2018–2019 totaled 8124 students, a 164% increase from 3079 students in 2002–2003.

The AAMC said expansion has occurred through increases in class sizes at existing medical schools and the creation of new medical schools. Since 2002, 29 new accredited medical schools have opened, along with 17 new schools of osteopathic medicine, they report.

There is ongoing worry among medical school deans about GME opportunities. In the latest survey, 75% expressed concern about the availability of residency slots nationally, and 44% expressed concerns about their own incoming students' ability to find residency positions of their choice after medical school.

In addition, 85% of deans voiced concern about the availability of clinical training sites, and 88% expressed concern about the supply of qualified primary care preceptors. Forty-six percent of deans said they felt pressure to pay for clinical training slots; 53% of schools currently do not pay for clinical training for their students.

In a report released in April, the AAMC predicted a shortage of 122,000 physicians by 2032, including up to 55,000 in primary care and 66,000 in other specialties, as reported by Medscape Medical News.

To train more physicians in the United States, the AAMC said it supports a multipronged approach that includes passage of bipartisan legislation that would provide a "modest but critical" increase in the number of federally supported GME positions. The Resident Physician Shortage Reduction Act of 2019 is awaiting action in both the Senate and the House.

"The cap on residency positions will continue to exacerbate the projected physician shortage until Congress acts," Grover said. "The medical education community has done its part. Now, Congress must do its part by passing the bipartisan Resident Physician Shortage Reduction Act."

The latest survey was sent to the deans of 151 accredited US medical schools, and 137 (91%) responded. The full report is available online.

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