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Med school enrollment up but only partial solution to doctor shortage, educators say

Medical schools around the country continued to see enrollment grow in 2012. But educators warn that efforts to produce more physicians will mean little without more federal funding for graduate medical education.

Schools have worked to increase the pipeline of physicians in recent years by opening more than a dozen new allopathic and osteopathic medical schools and expanding existing schools, said Darrell G. Kirch, MD, president and CEO of the Assn. of American Medical Colleges. Now Congress needs to increase federal funding for GME, he said. Medicare funding for GME has been capped since the Balanced Budget Act of 1997.

“The medical schools have done their part,” Dr. Kirch said. “But unless Congress acts soon, there won’t be enough training positions for all of these doctors who graduate to go out and practice in our communities. We can’t ignore this problem.”

Physician shortages are projected to reach 90,000 by 2020, according to the AAMC Center for Workforce Studies.

There are about 115,000 physicians in residency programs nationwide, according to an Aug. 16 Health Affairs report. More than 95% of U.S. medical school seniors were matched to first-year positions on Match Day 2012, according to the National Resident Matching Program. About 23,000 physicians were assigned first-year residency positions, of which about 6,800 were non-U.S. citizens who graduated from international medical schools.

First-year enrollment at the nation’s 141 allopathic medical schools for fall 2012 rose to 19,517 students, a 1.5% increase from 2011, according to AAMC data released Oct. 23. Annual increases have hovered around 2% for the past eight years. First-time applicants to allopathic medical schools increased 3.4%, from 32,654 in 2011 to 33,772 in 2012.

Allopathic medical schools are on track to meet the AAMC’s goal set in 1996 to expand enrollment 30% by 2016, Dr. Kirch said. Eleven new allopathic schools have opened since 2007, and four more are scheduled to begin their first classes in fall 2013.

First-year enrollment at the nation’s 26 colleges of osteopathic medicine increased 2.9% from 2011 to 5,804 students, said the American Assn. of Colleges of Osteopathic Medicine. Total enrollment at osteopathic schools is more than 21,600 — up 4.5% from 2011 — and accounts for 20% of U.S. medical students.

“We are very pleased and encouraged by the latest figures,” said Stephen C. Shannon, DO, MPH, AACOM president and CEO.

That growth is expected to continue with three new osteopathic schools scheduled to open in 2013 in Alabama, Indiana and North Carolina. Several others are being planned.

Dr. Shannon attributes the increasing interest in osteopathic schools to rising awareness of the important role of DO graduates in meeting future health care demands. The overall health care system is evolving into a more patient-centered approach based in communities and primary care, all of which are integral to osteopathic medicine, he added.

“There is widespread acknowledgment that physicians are going to be needed and that it’s a good career pathway, even with the changes and challenges that are coming,” Dr. Shannon said.

Allopathic medical schools also saw gains in the number of minority applicants and enrollees. A record number of blacks and Hispanics are enrolled as first-year students at AAMC schools, with 1,416 and 1,731, respectively, the AAMC said.

“We really saw solid gains this year among all underrepresented groups,” Dr. Kirch said. “The American population is becoming more diverse, and we need our physician pool to reflect that.”

Osteopathic schools are seeing some increases in minority enrollment, but more is needed, Dr. Shannon said. For example, the number of applications from blacks increased 5%.

There are many ways to raise the number of GME slots, Dr. Shannon said. AACOM is exploring how GME can be done differently, such as shortening the number of years physicians train, he said.

“Medicine continues to be a very attractive career choice for our nation’s best and brightest,” Dr. Kirch said. “Given the urgent need our nation has for more doctors to care for our growing and aging population, we are extremely pleased with the continued growth in size and diversity of this year’s entering class of medical students.”

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