Med Schools Boost Enrollment, But Residency Slots Threatened

The nation's medical schools are on track to boost enrollment 30% by 2016, but they may not have residency slots available for all of their new graduates, the Association of American Medical Colleges reports.

AAMC lobbyist Christiane Mitchell says federal funding for graduate medical education programs is under siege on several fronts, and that graduate education at the nation's medical schools has been targeted for as much as $60 billion in cuts over the next decade.

"We are very worried about a potential bottleneck and that we will see more qualified applicants for residencies than there will be slots," Mitchell says. "We are very concerned that that could happen in the near future. And that will be sped up by the federal cuts in GME support. That is a very real concern."

"If there were a significant cut in residency slots, you would see teaching hospitals reducing the size of their programs and maybe eliminating some training programs. That would be an immediate impact," she told HealthLeaders Media.

The AAMC's annual 2011 Medical School Enrollment Survey found that first-year medical school enrollment is projected to reach 21,376 in 2016-17, a 30% increase above first-year enrollment in 2002-03 and in line with the 30% increase by 2015 that the AAMC called for in 2006.

The 125 medical schools that were accredited as of 2002 will account for 58% of the projected 2002-2016 growth in enrollment, 25% will occur in schools accredited since 2002, and 17% will come from schools that have yet to be accredited, the survey found. While some of these increases happened during the economic downturn of the past few years, 52% of the medical schools responding to the survey expressed concerns about their ability to maintain or increase enrollment due to the economic environment.

"We have to keep in mind that teaching hospitals now without any federal support at all fund 10,000 training positions. The likelihood of seeing those slots disappearing first is very real. And if there are fewer and fewer training opportunities, you might see fewer and fewer talented young people thinking about a career in medicine," Mitchell says.

AAMC has estimated that the United States faces a shortage of more than 90,000 primary care and specialty doctors by 2020 to treat a growing population that includes an aging Baby Boomer generation. In addition, if the Affordable Care Act survives a constitutional challenge, an additional 32 million Americans would be covered by health insurance.

Medical schools generate much of the revenues that keep them open through the clinical practices of their faculties, who often provide care to underserved patients. "Not only do we face cuts, but we still are going to be taking care of those patients because no one else in the community is willing to because there is no money it," Mitchell says.

In addition, medical schools could also see a reduction in research funding, as Congress eyes cuts budget cuts at the National Institutes of Health. And cash-strapped states across the country are cutting Medicaid funding, another source of revenue for medical schools.

"We are educating Congress and the administration. We spend a lot of time pointing out the current shortage and how it will be exacerbated over the next several years because many physicians will be retiring," Mitchell says.