Increasing residency slots could help reduce physician shortages
■ Medical schools have increased enrollment, but a lack of residency positions could present a roadblock to boosting the physician work force.
By Susan J. Landers — Posted July 17, 2009
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Washington -- Congress should ensure that health system reform legislation includes provisions that increase the number of Medicare-supported residency positions to help reduce projected physician shortages, said the Assn. of American Medical Colleges.
Such provisions are part of bills introduced in May in the Senate and the House of Representatives, said AAMC Chief Advocacy Officer Atul Grover, MD, PhD, during a June 30 briefing. The meeting was held to emphasize the role that an increase in residency positions would play in alleviating physician shortages, a concern voiced in the health system reform debate.
The bills would expand the number of residency positions by 15% -- an increase of about 15,000 residency slots, according to the bills' sponsors.
"The bottom line is that the caps on resident training positions funded by Medicare are restricting the ability of medical schools and teaching hospitals to increase the nation's physician work force," Dr. Grover said.
The bills call for lifting the cap placed by the Balanced Budget Act of 1997 on the number of resident physicians each teaching hospital can claim for reimbursement under Medicare. Medicare generally does not reimburse such hospitals for training residents beyond the capped number of slots. The bills are supported by the American Medical Association.
The measures' provisions should be folded into health system reform legislation now being crafted in congressional committees, the AAMC said. "Congress' efforts to develop comprehensive health care reform are the best opportunity that the nation has to address the Medicare caps," said Dr. Grover.
An AAMC report released last fall concluded that the nation could face a shortage of 125,000 to 159,000 physicians by 2025, said Edward Salsberg, director of the AAMC Center for Workforce Studies.
To help meet the demand, medical schools are enrolling more students -- about 6,000 additional graduates per year. But without a parallel increase in residency positions, those students will not have vital training opportunities, Salsberg said.