Medical schools increase enrollment to meet future demand

Consensus is growing that a physician shortage lies in the near future, though questions remain over how large it will be and how to best address it. Medical educators are taking shortage predictions seriously and are ramping up class sizes.

Edward Salsberg, director of the Assn. of American Medical Colleges Center for Workforce Studies, said, "We really need to see this increase in U.S. production now in order to be prepared for the likely future demand for services."

Final data from a 2005 survey by the AAMC Center for Workforce Studies show that allopathic medical schools plan to add 1,400 to 2,000 first-year medical students by 2015-16, a 9% to 12% increase over the entering class in 2002-03. Add in osteopathic expansion of 2,000 to 2,500 more students, and a total of 3,400 to 4,500 additional first-year medical students could be in the 2015-16 pipeline.

According to the AAMC, 65 allopathic schools have increased enrollment since 2000, or have plans to do so. Allopathic schools in states that have experienced rapid population growth are the most likely to expand, particularly in the South and West. Also, the majority of increases appear to be coming from public institutions and at community-based schools rather than research-intensive programs. Eleven schools reported they would focus on increasing minority enrollment and enrollment of those wanting to practice in underserved areas. The AAMC anticipates that five new allopathic schools out of a possible 15 under consideration will likely come to fruition between 2007-08 and 2015-16.

However, those increases may not be enough to meet patient demand. The United States would need roughly 10,000 to 15,000 more first-year students by 2015-16 than it had in 2002-03, if a target of 85,000 new physicians were added to the work force by 2020, according to the AAMC.

If a 30% jump in allopathic enrollment were seen, the AAMC said this would mean an additional 33,000 MDs by 2020, or 55,000 more physicians when including new osteopaths.

This starts to fill the gap if one is expecting a shortage of 85,000 physicians but misses the mark when considering some experts' predictions of a need for 200,000 more physicians.

"We have to increase the number of first-year [resident] positions by 10,000 as soon as we can," said Richard Cooper, MD, professor of medicine and senior fellow at the University of Pennsylvania's Leonard Davis Institute of Health Economics, Philadelphia. "Every year we delay we fall behind."

The AMA supports the idea that there are current physician shortages in some geographic regions and medical specialties.