Every year around Match Day, medical and pre-med students alike worry about a rumored “residency cliff.” The theory is that the number of new medical school graduates will soon outstrip the existing inventory of residency positions, and the overflow applicants will be left in professional limbo.
While that picture seems scary, it’s time for some good news. I’ve believed for years that this concern is more phantom than real, but now there is empirical evidence in the form of a data analysis by a respected source in the New England Journal of Medicine (NEJM).
Dr. Fitzhugh Mullan, a longtime observer of physician workforce trends, published a report in the NEJM examining recent and projected growth of U.S. medical school enrollment, compared to the rate of increase in residency program positions. Mullan concludes that while the number of graduates has begun catching up with the number of available positions, this gap is narrowing very slowly. In 2024, the number of available residency slots will still exceed the number of U.S. medical school graduates by around 4,500. That means an ample supply of postgraduate training positions for new MDs from not only U.S. schools but deserving international medical graduates as well.
Put another way, residency positions are gradually becoming more competitive, but this is no reason to abandon a dream of becoming a physician; especially not when we as a nation face a growing shortage of physicians.
A 2015 study puts this physician shortfall at as many as 90,000 doctors by the year 2025. This number helps put America’s health care problems into perspective. While U.S.-based medical schools are slowly increasing enrollment, they cannot alone make up the gap in the physician workforce. So do we then look to recruit doctors away from Africa, Asia or Latin America, contributing to the “brain drain” from less affluent countries? Thankfully we don’t have to.
Many strong candidates are turned away from U.S. medical schools due to a lack of capacity and the resulting arbitrary cut-offs. International medical schools like mine — with a student body made up of mostly of U.S. citizens planning to practice in the U.S. — are doing their part to address the physician shortage by making more room for qualified American applicants. Many of my school’s graduates go on to become primary care physicians or to care for underserved populations — and some do both.
Detractors of Caribbean medical schools have often exploited pre-med students’ residency anxiety to frighten them away. Mullan’s important report in NEJM should help lay that to rest.
Heidi Chumley is executive dean and chief academic officer, American University of the Caribbean School of Medicine.
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