The American Association of Medical Colleges (AAMC) has recommended that medical schools increase enrollment by 15% by 2015 due to exploding health needs of an aging U.S. population. If schools comply with this recommendation, the number of physicians would increase by 2,500 per year, the AAMC estimates.
A total of 67,656 medical students were enrolled in U.S. medical schools as of October 2004, according to the medical group.
The Washington, D.C.-based organization took several factors into account in recommending that medical schools train more future physicians, including the stepped-up medical demands of the Baby Boom generation, which begins to retire in 2011; the retirement of practicing physicians; and the trend toward younger physicians working fewer hours.
"Given the extended time it takes to educate and train tomorrow's doctors, efforts to increase enrollment must get under way as soon as possible to assure that the healthcare needs of the nation in 2015 and beyond are met," said AAMC President Jordan J. Cohen, MD.
Despite a slight increase in applications to the 125 U.S. medical schools (both allopathic and osteopathic) during the past two years, the number of students accepted into the entering class has remained steady at about 16,000 per year, according to Dr. Cohen. Raising the number of students who apply and are accepted into medical school from current levels "will not be a problem," Dr. Cohen told Medscape. "The applicant pool is already rich."
As part of its recommendation to boost enrollment, the AAMC believes expanded student enrollment should occur in regions such as the West and Southwest, where population growth has been strongest and is expected to continue. "It seems likely that schools will be most inclined [to boost enrollment] in areas where the population has increased and there are more students to draw from," Dr. Cohen noted.
Nonetheless, medical schools across the country are already thinking about expanding their class size or are making plans to do so, a 2004 survey of 118 allopathic schools by the AAMC found.
One third of schools (31%) said they were "definitely" or "probably" going to boost first-year enrollment over the next several years, which would translate into a 4% increase in physician supply. And another 23 schools (20%) said they would "possibly" increase enrollment over the next six years, the survey found.
Unlike the late 1960s and early 1970s, when the federal government played a significant role in expanding medical school capacity through grants, such assistance is not likely in the near future, Dr. Cohen predicted. As a result, state-sponsored medical schools interested in boosting their enrollment may depend more heavily on their state legislatures for support.
As part of its recommendation to boost medical school enrollment, AAMC also called for removing the current restrictions on the number of residency and fellowship positions funded by Medicare. The federal government spends approximately $2.2 billion in so-called direct medical education payments to medical school–affiliated teaching hospitals, which provide clinical training to residents and fellows.
The removal of the restriction on Medicare-funded residency and fellowship positions is necessary if the pool of physicians-in-training is to be expanded, Dr. Cohen said. "Medicare is the major funder [of graduate medical education] and it will be extremely hard for hospitals to find other sources to expand physicians training" if the restriction stays in place, he said.
Reviewed by Gary D. Vogin, MD