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Over the last several years, much has been written on the statistics that predict a shortage of residency spots given the opening of several medical schools and the relatively stable number of graduate medical education slots. The decision to create more options for undergraduate medical education was predicated on the predicted future physician shortage.
Data recently released on the 2014 Match(SM) by the NRMP(R) show that the gap between numbers of allopathic medical school graduates and PGY-1 positions has remained fairly stable. Since 2002, the combined number of graduate students from U.S. allopathic and osteopathic schools has been lower than the total number of available first year positions in NRMP and AOA matches. At a recent graduate medical education meeting that I attended, interestingly, there was no talk of an impending shortage of residency spots. Perhaps this was because the number of residency slots in the match has increased at a greater rate than the number of medical school graduates, and that the 2014 match results revealed a relatively stable IMG match rate.
It may be too soon to make any predictions about the next several years. It is still expected that there will be more U.S. allopathic medical school graduates in future matches. Over the last two years, available residency spots through the NRMP increased due to the “all in rule,” and it will likely take more time to understand the impact of this recently implemented rule on the overall data. There is still a cap on residency positions that may not be increased given fiscal realities. It is not yet clear what the actual medical school graduate and residency spot availability mismatch will actually look like. A primary care physician shortage is predicted given the aging of the “baby boomers,” the percentage of physicians expected to retire, and the influx of patients into the health care system as the provisions of the Affordable Care Act expands insurance coverage.
An analysis of the present and projected healthcare workforce as well as the identification of physician shortage specialties must not only be done intelligently and comprehensively, but must be accepted by all stakeholders. It is difficult to know how to counsel prospective physicians given the present climate of uncertainty. In the meantime, anyone seriously considering a future in medicine should strive to understand the forces affecting medical education and health care in this country. Now more than ever, a complex understanding of the principles that underlie the delivery of healthcare will be necessary for the successful candidate. To maximize your chances of achieving your dream of becoming a physician and to minimize anxiety, consider the following:
- Be goal-oriented and absolutely certain that you are well suited to the demands of medicine and up to the challenge.
- Remember that medicine is a “calling,” and that you should be thinking about how you can contribute meaningfully to the profession.
- Follow the health care debate and the implications and provisions of the Affordable Care Act closely.
- Be optimistic as events unfold – remember that if a career in medicine is truly meant for you, you will be successful.
