Profession

Medical schools increase enrollment to meet future demand

But physician shortage fears remain.

By Myrle Croasdale — Posted May 15, 2006

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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.

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ADDITIONAL INFORMATION

The physician pipeline

Work-force experts project a shortage of 85,000 to 200,000 physicians by 2020. Here's a look at how many more first-year medical students are expected versus what experts say the need will be.

First-year medical students
(2002-03)
19,567
Estimated class size based on expansion plans at existing schools and new schools under consideration 22,912-23,997
(17%-23% increase)
Estimated class size needed by
2015-16 to fill shortage
29,351-34,242
(50%-75% increase)

Sources: Assn. of American Medical Colleges Center for Workforce Studies, Council on Graduate Medical Education, and original reporting by Myrle Croasdale, amednews staff

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Residency positions key

Without more residency positions, physician supply won't increase. Richard Cooper, MD, professor of medicine at the University of Pennsylvania's Leonard Davis Institute of Health Economics, suggests that even by adding 1,000 more first-year residency positions (PGY-1) annually starting in 2010, physician supply won't come near to matching demand by 2025.

Physicians per 100,000 population
Change in
PGY-1/year in 2010
PGY-1 Demand None +500 +1000 Demand
1983 201 211 2003 274 274 274 280
1984 206 214 2004 275 275 275 283
1985 212 217 2005 275 275 275 287
1986 216 220 2006 276 276 276 291
1987 220 223 2007 276 276 276 295
1988 225 227 2008 277 277 277 299
1989 228 230 2009 277 277 277 303
1990 231 233 2010 277 277 277 307
1991 235 236 2011 277 277 277 311
1992 238 240 2012 277 277 277 315
1993 241 243 2013 277 277 278 319
1994 245 247 2014 277 278 278 323
1995 249 250 2015 276 278 279 328
1996 252 254 2016 276 278 280 332
1997 256 257 2017 276 279 282 336
1998 260 261 2018 275 279 283 340
1999 264 265 2019 275 280 285 344
2000 268 268 2020 274 281 287 344
2001 271 272 2021 274 282 290 348
2002 272 276 2022 273 283 292 352
2023 273 284 295 356
2024 272 285 298 361
2025 272 286 301 365

Source: Richard Cooper, MD, April presentation

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