A “residency bottleneck” exists.
More and more students are enrolling into medical school and graduating, yet the number of residency slots available is capped. Graduates need these residencies to complete their training and become licensed physicians. But Congress, which controls funding for most residency programs, has frozen the number of subsidized spots since 1997. If we want to address the physician shortage, we need to fix this problem.
Luckily, there is a solution.
Rep. Joe Crowley (D-Bronx, Queens) supports legislation that would expand the current cap on the number of Medicare-funded training slots for doctors. The Resident Physician Shortage Reduction Act, backed by a record-high 100 bipartisan members, would increase the number of residencies nationwide by 15,000 over five years — a 15 percent increase from the number of spots open in 2013. It would provide enough funding for New York State to train an estimated 500 additional residents annually.
Dr. Darrell G. Kirch, president and CEO of the American Association of Medical Colleges, applauded lawmakers, saying the bill “would begin to alleviate the doctor shortage facing the nation by allowing medical schools and teaching hospitals to train between 3,000 and 4,000 more physicians a year.”
But this is only one step toward addressing the physician shortage. This legislation falls short of addressing other problems such as the shortage of primary care physicians. The Association of American Medical Doctors projects that by 2020 there will be a shortage of 45,000 PCPs. Today only 30 percent of all physicians practice primary care (compared to about 70 percent in most other developed countries).
Not many medical students are choosing to go into primary care because of low compensation compared to specialty care. If we are to endorse raising the caps of residency slots, we need to make sure the absolute numbers of PCP vs. specialist slots are close to even. There need to be incentives to push more medical centers and training hospitals to invest in PCP residency slots.
We have an impending crisis on our hands. The demand for physicians is expected to increase, especially with the passage of the Affordable Care Act, adding 32 million Americans who will become newly insured and eligible for Medicare. Not to mention the aging population. Baby Boomer physicians are retiring and as the Baby Boomers age, more primary care is undoubtedly needed. Lifting the cap on Medicare-funded residency slots is a good start. Yet, more must be done.