Category Archives: AAMC

March 26, 2015

A Shortage Of 90,000 Doctors Expected By 2025

Residents

Recently there has been a lot of talk about the lack of students enrolling in medical studies. The medical school association fears that if this trend continues, we will see a shortage of 90,000 doctors by the year 2025.

Perhaps the greatest foreseen shortfall will occur in the demand for surgeons.  In particular, surgeons who treat diseases more commonly found in older adults, such as cancer.  ”An increasingly older, sicker population, as well as people living longer with chronic diseases, such as cancer, is the reason for the increased demand,” Darrell G. Kirch, the AAMC’s president and chief executive, told reporters during a telephone news briefing.

The Association of American Medical Colleges (AAMC) has feared a doctor shortage for the past few years, which is why they have been making efforts to support legislation that would funnel more federal money toward its members.  These members include 400 of the nation’s teaching hospitals and 141 medical schools.  The legislation – Resident Physician Shortage Reduction Act of 2011 – was proposed for a second time in 2013 and calls for Congress to provide $1 billion a year to support 3,000 more medical residents at hospitals.

Since 1965, Congress has used Medicare and Medicaid to assist in funding the one-year residencies that 28,000 medical school graduates complete each year at the nation’s top teaching hospitals.  On average, it takes about $152,000 to train a resident and the government reimburses hospitals for a portion of that cost through payments in a program called Graduate Medical Education (GME).  In 2012, $5 was spent on GME, which was solely funded by Medicare, according to the Institute of Medicine.  A fact sheet accompanying the estimates says that since 1997, Medicare support for doctors in training has not grown, despite an increase in the number of residents.

Criticized for “wasteful spending” and “lack of accountability”, the AAMC is having difficulty arguing their case to unfreeze GME funds.  Teaching hospitals must report back on how the money is used and could lose it if their residents drop out or don’t pass their boards.  Indirect payments, on the other hand, require no reporting or performance-based standards.

Although it is difficult to know exactly how teaching hospitals are spending the indirect payments, the Medicare Payment Advisory Commission (MPAC), which regularly reviews aspects of Medicare in order to advise Congress, has found that $3.5 billion of these payments are being spent on things unrelated to the training of new doctors. MPAC advises the money be rerouted to a transparent fund that would reward the most productive residency programs and thus put the funds to their best use.

Over the next 10 years, the number of Americans over the age of 65 is expected to increase by 36 percent.  In addition, 32 million younger Americans will become newly insured as a result of Obamacare.  The scary part is that the number of doctors to treat those Americans will grow by only 7 percent, according to the AAMC.

Access to care could get worse for some people before it gets better, said Dr. Andrew Morris-Singer, president and co-founder of Primary Care Progress, a nonprofit in Cambridge, Mass. “If you don’t have a primary care provider,” he said, “you should find one soon.”

AMP Paperless Admissions is helping medical training programs across the U.S. maximize their enrollment process; further encouraging students to pursue a career in the medical field.

November 6, 2013

Takeaway from the 2013 AAMC Annual Meeting

We are finally back in Pittsburgh after a long, eventful weekend in Philadelphia for the AAMC Annual Meeting! We hope you were able to stop at our booth this year to talk to an admissions expert about AMP. If you didn’t have the time to say hello, please feel free to schedule a demo of AMP.

2013 AAMC Annual

This year’s meeting was bigger than ever with over 5,000 attendees, making it one of the largest gatherings of leaders in academic medicine. This premiere event in academic medicine allows leaders from all different institutions and backgrounds to give fresh perspectives on current academic medicine issues, news, trends, and concerns.

A variety of sessions were held, with topic discussions ranging from MOOCS to GME to the doctor shortage.This year, there has been constant discussion about what can be done to moderate the Affordable Care Act’s effect on academic medicine. In a session titled ‘Envisioning Changes in Health Care,’ Dr. Ian Morrison, health care futurist and author, discussed the rapidly changing landscape of health care and the impact of the Affordable Care Act on academic medicine.

Another topic of concern for attendees is the affect of the recent government shutdowns on academic medicine. A session led by Dr. Darrell Kirch, the AAMC CEO and President, discussed how the government shutdown has made it more difficult for institutions to accomplish their missions in education, clinical care, and research.

One of the most pressing topics discussed was the shortage of doctors and how institutions can manage the shortage of residency programs at medical schools and hospitals. Currently, medical school applications have reached record highs, with a 5.8% increase from 2012 to 2013. This increase, as well as increased enrollment at osteopathic schools, helps to alleviate the doctor shortage issue. However, this increased enrollment will soon highlight the lack of residency positions available to medical students. This past year, 528 medical school graduates were unable to find a job among the government’s 115,000 government allotted residency programs. If the current increase in residency slots of 1% per year continues, hospitals will be 2,000 positions short for graduates by 2021. This is very concerning for medical school graduates, who have an average of $180,000 in debt. Students can’t afford to not find a job immediately after graduation. At the AAMC annual meeting, the greatest minds in medicine get together to strategize solutions to complicated issues such as the doctor shortage.

This year’s AAMC meeting highlighted many important topics related to academic medicine. This opportunity to share ideas will enable the attendees to evaluate their best practices in managing their school, with the resources that are available. The annual meeting is always an excellent opportunity for attendees to learn more about the latest in academic medicine, and we cannot wait to attend next year’s meeting in Chicago.

April 5, 2013

FlexMed at Mt. Sinai: Med School without the MCAT

The Mt. Sinai Icahn School of Medicine recently announced a daring new admissions plan that would populate half of each class with students who were accepted as undergraduate sophomores, without requiring the Medical College Admissions Test (MCAT) or certain premed requirements like Organic Chemistry. The new program, FlexMed, allows premedical students to pursue undergraduate degrees in the humanities instead of being immediately pigeonholed into a rigorous science curriculum. After acceptance into the FlexMed program, students are required to maintain a 3.5 GPA and attend a remedial science course during the summer before the first year of med school (assuming that they had skipped the science prerequisites).

The FlexMed program was borne from the success of a similar small-scale program that admitted a limited number of humanities undergraduates into the School of Medicine. In a study published by Academic Medicine, Mt. Sinai found that academic performance in medical school was equivalent for the humanities students and traditional premed students. The smaller program was part of a larger effort from the American Association of Medical Colleges to reevaluate the medical admissions process and to seek out atypical applicants. “We must consider whether current premedical education requirements — some a century old —”fit” with how basic science and medical practice have changed,” says AAMC President and CEO Darrell G. Kirch, M.D.

Commenting on the status quo in medical school admissions, Dr. Kase of Mt. Sinai said, “The default pathway is: Well, how did they do on the MCAT? How did they do on organic chemistry? What was their grade-point average? That excludes a lot of kids… it makes science into an obstacle rather than something that is an insight into the biology of human disease.” The FlexMed program is a method to move away from the status quo. In a press release from Mt. Sinai, Dennis S. Charney, MD, the dean of the medical school, said:

“The current model of medical school training has stagnated despite major advances in science and medicine. We want to attract students with bright, creative minds who understand the role of precision medicine and big data and want to change the world. We also want innovators in clinical care who think of medicine in the larger social context and identify new practices for better care delivery. We believe FlexMed signals a paradigm shift in how we select, prepare, and educate the next generation of physicians, and hope other medical schools will follow suit.”

The end goal of this program is to produce a more diverse medical community that has a broader insight into the human condition. However, some people are skeptical at discarding the pre-med curriculum. One Chronicle commentator had an interesting view on the FlexMed program and others like it:

Are they really saying that doctors need so little understanding of biology that it could be completely covered in a six week long remedial course? This seems quite unlikely, being a physician is to biology like being an engineer is to math and physics; ie the applied side of the same field. However, maybe this is actually an acknowledgement that our current US system with four years of college prior to medical school just restricts the production of doctors and increases medical costs.  In almost all other countries in the world, being a doctor is just a four to six year bachelors/masters level degree.  It seems like such trends are making it harder and harder for US medical schools to justify the need for a bachelors degree prior to entering medical school…

With such a prominent medical school making such a drastic shift in admissions procedures, it should be very interesting to see if other schools follow suit in the coming semesters. For any school that is contemplating an alternative admissions process such as FlexMed, the infinitely customizable AMP online admissions system is a perfect tool for implementing a new admissions workflow with ease.

December 11, 2012

The Doctor Shortage & Medical Admissions

The Origin

AAMC Physician Supply & Demand ChartA perfect storm is brewing in the American healthcare system; too many new patients and not enough new doctors.

The U.S. is experiencing a demographic shift. The Baby Boom population is aging and increasing the numbers of elderly patients who require healthcare for age-sensitive conditions. Those numbers will continue to rise for many years to come. The Affordable Care Act (“Obamacare“) is a less influential factor that will allow 30 million new patients access to insured healthcare.

“This is a national problem across the board and it is going to get much worse,” said Christiane Mitchell, director of medical affairs for the [Association of American Medical Colleges]. “We have an aging population and a whole lot of doctors retiring. We need to increase the pipeline of new doctors.”

It is estimated that the U.S. will need 65,000 additional primary care doctors by 2025. That sounds like a long time to prepare, but it takes a decade for most doctors to complete their schooling – action needs to be taken right away in order to avoid a crisis.

Implications for Patients

With fewer available doctors, patients will soon feel the healthcare pinch.

As a solution, The American Academy of Family Physicians believes that the best way to reduce the shortage is through patient-centered medical homes. The medical home is a team-based approach, where every patient has a personal physician who leads a team of professionals, including nurse practitioners, physician assistants, nurses and other health care professionals. With plenty of staff support for a small number of M.D.’s, patient care is streamlined.  However, the Association of American Medical Colleges (AAMC) doesn’t believe that medical homes are the cure-all solution for the looming shortage. Team-based approaches may help reduce the shortage, but will not eliminate it.

Why don’t we have enough Family Physicians?

The doctor shortage isn’t really a “Doctor” shortage per se; there are 17,364 new doctors that graduated in 2011 according to the AAMC. The real problem is that too few of those doctors chose primary care as a career, preferring to specialize in more lucrative areas of medicine.

In a 2008 census by the AAMC and the American Medical Association, research revealed that the number of medical graduates choosing a career in family medicine dropped nearly 27 percent. This is partially a financial decision; primary care physicians in the United States make $140,000 to $150,000 annually, but specialists can make up to 2-3 times as much. For medical school students buried under a mountain of debt after 10+ years of schooling, choosing a more lucrative career choice is the logical course of action.

Students also take into consideration their future satisfaction in their chosen field. During medical school, 2-week rounds of clinical rotations is where students get first-hand experience in many different medical specialties. In these clinical rotations, Dr. Phillips of Harvard said that medical students often observe “primary care doctors unhappy doing with what they are doing…Practicing [family] doctors feel overworked and under supported and are generally unhappy,” he added. Clinical rotations don’t do justice to the benefits of a career in primary care; the true payoff in family medicine comes from long-term relationships with patients. “The values of primary care don’t come out in a two-week rotation. You don’t get that experience that a primary care physician loves,” said Jon Kole, a fourth-year medical student at the University of Pennsylvania.

Implications for Medical Admissions

Many academics say that medical schools could do a lot more to encourage students to study primary care, and it all starts in the Admissions department. Professors suggest that admissions could select more students whose applications indicate a preference for family medicine. The AAMC has also put forth an initiative urging all U.S. medical schools to increase enrollment by 30%. According to the AAMC’s annual enrollment survey, many schools will have met that goal by 2016.

Some schools are already trying to counteract negative perceptions about family medicine. Seeing an opportunity to fill a gap, New York’s Mount Sinai School of Medicine is starting a new Department of Family Medicine. Dr. Dennis Charney, dean of the medical school, says “It’s a big deal for our institution. We want to be one of the leading medical schools that educates the next generation of primary care doctors.”

Schools can’t do it all alone, though. Amidst a climate of deep budget cuts for education, Congress must switch gears and support medical education funding, especially for primary care physicians. The U.S. government has already offered financial incentives such as loan repayments and scholarships to get doctors to practice in under-served areas.

“As a result of ongoing budget discussions, cuts to doctor training will worsen the physician shortage and jeopardize the health of patients around the nation.  It takes years to train a doctor.  For more doctors tomorrow, there must be increased funding for doctor training today,” says the AAMC

A good defense is the best offense

Medical schools must take action now in anticipation of the doctor shortage. They can begin by re-evaluating the end goal of their admissions procedures and adjusting school culture to be more encouraging of family care physicians. For example, Texas Tech is trying to encourage students to choose family medicine, by reducing the cost of medical school with an accelerated three-year program that allows primary care physicians to graduate a year early.

AMP is another example of an admissions tool that medical school admissions offices can use to prepare for this complicated and ever-changing world of medical admissions. Customizable applicant reports can allow admissions staff to efficiently evaluate the demographics of students, including ratios of how many students are interested in family medicine vs. pursuing a specialty. Visit Paperless Admissions to learn about how AMP can streamline and help your admissions office better evaluate applicants in your medical admissions process.