Fixing the doctor shortage – my two cents

I want to add a quick note to Sarah Kliff’s coverage of Alex Wayne’s piece on the doctor shortage. Specifically this (emphasis mine):

Medical schools are holding back on further expansion because the number of applicants for residencies already exceeds the available positions, according to the National Resident Matching Program, a 60-year-old Washington-based nonprofit that oversees the program.

While it is true that the overall number of applicants exceeds the available positions, there are a number of things hidden in there worth noting.

First of all, this is less true in some specialties than others. If you’re going for a very competitive specialty (think dermatology), then yes, there are many more people than spots. But in less competitive specialties (think pediatrics), that’s not necessarily the case. And, yes, I’m a pediatrician.

Second, there are also sometimes fewer American applicants than there are positions. Many foreign-educated students apply for residency positions in the US, and get them. I’m not saying this is a bad thing, but we sometimes have fewer medical students in the US than you’d think, too.

Moreover, there are unfilled residency spots almost every year. That’s because while lots and lots of people may be willing to train in NYC, far fewer students may be willing to train in Indiana. And, yes, I live in Indiana. Complaining that we don’t have enough residency spots in the US when there are open slots available is like complaining you can’t go to college because you only applied to top tier schools and didn’t get in. There were 1100 unfilled first year residency slots in the US in 2012.

I actually still agree that we likely need to train more physicians, and will need more slots. But the issue is more nuanced than many think.

Actual data here: http://www.nrmp.org/data/resultsanddata2012.pdf

@aaronecarroll

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