Worsening of shortage of residency slots feared

(HealthDay)—Despite a looming physician shortage, the number of residency positions in the United States has not changed since 1996, creating a bottleneck that will become worse with further budget cuts, according to a blog post published Dec. 7 on KevinMD.com.

Nathanial Nolan, a second-year medical student at the University of Missouri School of Medicine in Columbia, and a member of the American Medical Association Medical Student Section Committee on Medical Education, writes that according to the National Resident Matching Program, 34,355 U.S. and international medical students were competing for 26,392 positions. Medical schools are increasing class sizes to address the estimated physician shortage (estimated at 60,000 in the next two years), creating a further bottleneck.

According to Nolan, the problem is that the funding of graduate medical education is directly tied to Medicare and indirectly tied to Medicaid. The Balanced Budget Act of 1997 mandated that reimbursements to hospitals for training doctors be frozen at 1996 levels, so hospitals do not receive additional reimbursement for training additional physicians. The 2014 budget proposes $11 billion in Medicare cuts over the next 10 years, which would reduce funding for graduate medical education from Medicare by about 10 percent a year. The American Medical Association has launched the Save GME campaign.

"Residency positions are important to the health of our nation and the health care system," Nolan writes. "As our nation ages and faces a dramatic increase in the insured population, we cannot afford to face a shortage. As a student of public health, I fear the repercussions for the U.S. health care system. As a medical student, I fear the repercussions for myself."

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