Med Students May Encounter Problems on Match Day

Doctors working on patient We all know that there is a shortage of physicians in this country. And, while you’d think that growing medical school classes would be a good thing, it’s turning out to be a problem. Why, you may ask? The problem is that residency programs aren’t growing as quickly. And, as a result, last year, there were well over 500 unmatched graduating medical students and it only looks to get worse.

This year there were 20,000 first-year medical students –a record number –and that number is expected to continue to rise. But, residency program slots have generally remained steady over the last 20 years. This is because of the Medicare funding cap placed by Congress in the Budget Control Act of 1997. (Medicare is largely how residencies are funded.)

While additional money is being held-up in Washington, the good news is that several organizations and states have started to find their own solutions that may benefit medical students:

1. Nova Southeastern University College of Osteopathic Medicine in Ft. Lauderdale, Florida has teamed with the State’s Department of Corrections to offer a correction medicine fellowship for board-certified doctors (generally in primary care) to accompany its correction-based psychiatric residency. The University of Connecticut and University of North Texas are also looking to pair with their correctional facilities at all levels to form additional primary care residencies, too.

2. Because the state of Texas is facing a physician shortage, and the state was graduating more medical students than it had residency slots for, the state decided to help fund residencies to keep physicians in their state. In addition, some of the state’s recently allocated money will also go towards one-time grants to have new hospitals offer GME. But, the article cautions that this is a long, expensive process.

Also in Texas, Scott & White Hospital has used their own dollars to expand their GME positions — adding about 115 slots over the last 5 years.

3. Since 1974, Maryland has been collecting money from private insurance plans to help fund their state’s GME programs.

While the addition of GME residency slots is generally a good thing, the Medicare Payment Advisory Commission (MedPAC) has cautioned that many hospitals are only adding residency positions in high revenue-generating specialties –like neurology and oncology. And, it should be noted that MedPAC is leaning towards the idea that institutions should have to compete for future GME dollars –by demonstrating resident competencies and support from faculty –an idea that is expected to be supported by an upcoming Institute of Medicine report –possibly further changing the face of medicine. Medical students should stay-tuned.

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