Medical school applications reach new high

The number of first-time applicants to allopathic medical schools reached an all-time high of 32,654 students, a 2.6% rise from 2010, said an Assn. of American Medical Colleges report released in October.

Enrollment in medical schools grew at its fastest rate, 3%, since the turn of the century. More than 19,000 medical students matriculated in 2011, reflecting a nationwide push for expanded enrollment and students' interest in a career as a physician.

"These students view medicine as an inherently rewarding career," said Darrell G. Kirch, MD, president and CEO of the AAMC. "They want to help take care of patients and feel that the implementation of the Affordable Care Act has the potential to resolve inequities in our current system. This runs counter to the prediction that the legislation would detract from the appeal of medicine as a career. The evidence clearly indicates that it's doing the opposite."

The total number of applicants, first-time or otherwise, was 43,919. These applicants had an average Medical College Admission Test score of 29 (out of 45) and a 3.5 grade-point average.

Men still account for 53% of new medical students, about the same proportion the AAMC reported for 2001. Though the number of black and Hispanic students has grown 23% since 2004, they still lag behind the general population. For example, 12.6% of Americans are black, but only 7.2% of medical students are black.

First-year enrollment at osteopathic medical schools also is on the upswing, with a 3.7% increase in 2011. More than 20% of new medical students attend osteopathic schools, according to the American Assn. of Colleges of Osteopathic Medicine. The number of osteopathic medical students enrolled topped 20,000 students for the first time in 2011.

"Each and every new osteopathic physician will be needed to help meet our nation's increasing health care demands," said Stephen C. Shannon, DO, MPH, president and CEO of AACOM.

Residencies endangered

Allopathic medical schools have expanded overall enrollment 16.6% since 2002, when the AAMC called for a 30% enrollment increase by 2017 to help avoid an estimated shortage of 91,500 physicians by 2020. Yet producing more medical school graduates could be for naught if there are insufficient residency slots, Dr. Kirch said.

"We need to increase and continue the support that Medicare provides for residency training to ensure that students coming in today will be able to complete their training," he said.

The Balanced Budget Act of 1997 capped the number of Medicare-funded residency programs at about 100,000. Meanwhile, the number of states using Medicaid dollars to fund graduate medical education has fallen from 49 in 2005 to 41 in 2011. In September, President Obama proposed a 10% cut in Medicare GME funding, about $1 billion a year. The American Medical Association has policy opposing the residency-funding cap and has worked for greater GME spending.

The annual cost of training one medical resident is estimated at $100,000 annually, Dr. Kirch said. Medicare pays about $40,000 of that.

"I fear that hospitals, given the pressure they are facing on all fronts, are unlikely to continue to fund residents and are unlikely to expand residency support," he said. "Some of the smaller hospitals that have key primary care training programs, if they feel they are under duress, might close those residency programs."