Every year I hear about qualified premeds not getting into med school because there are so few spots. Why are qualified people being turned away if there’s a worsening doctor shortage in the US?
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It’s a barrier to entry so it keeps salaries for existing doctors high by keeping competition low. This is basically the case with every profession that has certifications or licensing to perform the job; electricians, plumbers, actuaries, lawyers, etc. People in the profession don’t *really* care if there’s a shortage because it only benefits them, their customers are the ones who care. Unfortunately, the customers don’t know shit about the profession so “those people weren’t smart/driven enough”, “it’s really hard/expensive to build a new school”, “not many people have the skills we need for our meagre wages”, etc. are accepted by the customers because how am I supposed to know who should or shouldn’t be a doctor.
This article goes into some detail:
[https://www.vox.com/22989930/residency-match-physician-doctor-shortage-pandemic-medical-school](https://www.vox.com/22989930/residency-match-physician-doctor-shortage-pandemic-medical-school)
As I read it the issues are:
– more residency applicants than places available
– lack of funding and political will to create more (something to do with medicare)
– very hard to recruit overseas doctors, although this wouldn’t help US medical graduates.
Biggest problem is residency being funded through Medicare. In no other industry is the hiring and training of the next generation publicly funded. It should be done away with completely. Every medical company/hospital has it in their best interest to hire and train new doctors. They could do it by contract. We’ll agree to train you for 4 years residency, if you’ll then agree to work for us for 4 years after, ect.
Also the “shortage” of doctors is largely localized. In other words, doctors want to live in particular areas, so they have too many. Meanwhile, shitty backwater poor communities, no one who went to med school wants to work there, so they don’t have enough.
A few problems- medical schools and residency programs would have to grow in sync, and the people with power over residency programs have no power over medical schools
Obamacare got a bunch of people to get insurance, which causes demand.
As the boomers hit 65, they get Medicare, so not only are they aging and need medical care, many will have insurance for the first time.
Finally, the biggest shortfall is in Primary care providers, who get paid less than specialists and have to be on call, leading to burnout
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Open positions for medical school are limited. Internship/residency is federally limited. Even if you could make more med school openings they can’t become practicing doctors without the residency, so you’d just saddle students with med school debt and no way for them to earn enough to pay it back.
Until there is a federal will to make it easier to create and expand residency options there will be a shortage of training and therefore stiffer competition.
When applying to residency, new doctors have to pick a speciality. They don’t just have a generic “residency”, but rather a program for neurology or one for orthopedic or ob/gyn, etc. Some programs are more popular choices than others for a variety of reasons (better $, better work hours, less after hours calls, etc.) Often med students are not realistic about the program they are trying for. The location is also an issue. Med school students apply to interview for various residency programs. Typically (covid years were exceptions) that means they get invited to interview at the school and that means the student has to buy their own ticket and make their own travel plans to show up at the interview. Time and money limit how many schools they can get to. Of those they do interview at, the student gets to rank them by favorite. The schools then also rank their interviewees by favorite. If all goes well, favorites match up. Sometimes the interview does not go well or the school has such a big pool to pick from that some just don’t get matched. The advisor for the student should be helping them establish realistic goals and attainable residency programs. Not everyone can be an orthopedic doctor in a big city. Sometimes they gotta be willing to move across country to start out.
The bigger bottle neck is residency. Residency is required in all 50 states to ontain a license. Imagine getting a loan for college and medical school at least 250k and being unable to obtain a license to practice your trade.
Our output of doctors has remained numerically flat since the 80s despite all the population growth.
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