Two months ago, 412 medical school graduates learned they would not have a place in the residency programs that should have capped their studies and led to a license to practice. That was more than a disappointment for them and their families; it was bad news for the nation.
Most of these students had done their part by working hard in college and during four years of medical school, often accruing massive personal debt in the process. But a lack of adequate federal funding for the country’s residency programs shut them out — the second straight year that has happened.
The problem will only get worse if nothing changes. The need for new doctors is growing exponentially, driven by three forces. The population is aging and requires more care. One-third of the physicians who practice today plan to retire in the coming decade. And the Affordable Care Act means more people have health insurance and access to doctors.
Federal investment in the next generation of doctors is not keeping up. The government pays most of the cost of residencies, but Congress has not budged from the cap of $1 billion it set in 1997. That’s enough for 115,000 doctors in training, far fewer than the country will need.
By next year, the United States will fall short by 63,000 doctors. That figure will leap to 130,000 by 2025, according to the Association of American Medical Colleges.
Medical schools have done their part, adding seats to their four-year training programs to get future doctors in the pipeline. However, without adding residencies, the funnel only gets more narrow, keeping qualified graduates from advancing toward a medical practice.
Expanding the pool of residents is not the only solution to the care shortage. Regulations must change so that nurse practitioners and physician assistants can practice to the full extent their training provides.
Most of the problems of the medical system defy simple solutions, but that’s not true of the residency shortage. Measures pending in Congress would raise spending to allow for more doctors. A House bill proposes adding 15,000 residencies over five years.
Like an infection that is left untreated, America’s doctor shortage will only get worse until lawmakers act.
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