Medical school enrollment continues to grow, but the opportunities to train in graduate medical education (GME), which are funded federally, have been stagnant for a generation. That fact creates a stressor for aspiring physicians and impedes the physician workforce from growing adequately to meet the needs of the nation’s aging population.
With the aim of averting the projected shortage of up to 124,000 physicians by 2034, medical students took to Washington, D.C., during the recent AMA Medical Student Advocacy Conference. Here are some key takeaways from a conference education session detailing the issue and why it is of such import to medical students.
The system burdens students
According to an AMA issue brief, nearly 8,500 medical school graduates did not initially match into a residency slot last year. Just over 5,000 of these unmatched students were able to scramble and find a position through the Supplemental Offer and Acceptance Program, but more than 3,000 students failed to locate an available position and, as a result, were unable to start residency and start providing physician care to their communities.
Alex Tolbert, a second-year medical student at Florida State University (FSU) College of Medicine and member of the AMA Medical Student Section offered some real-life perspective on what that disappointment can do to a trainee.
She noted the case of Leigh Sundem, MD, who died of suicide after twice failing to match to a residency position.
“These are real people with dreams, hopes, ambitions, fears and futures,” Tolbert said. “They are colleagues and friends worthy of achieving this shared dream.”
America needs physicians
The physician workforce, much like our general population, is aging. Nearly 45% of active physicians in the U.S. are 55 or older. Also, the nation’s aging population has more underlying health conditions and, therefore, requires an increasing number of physicians to deliver high-quality care.
As part of the conference, medical students met face-to-face with members of Congress or their staffers to detail the need for action. In coaching medical students ahead of the Capitol Hill visits, Christopher Sherin, the AMA’s assistant director of congressional affairs, gave some guidance on how to frame the topic.
The are certain “buzzwords on this particular issue,” he said, and “workforce is a particularly important one.”
Another, he added, is “access to care.” That is especially the case for patients from historically marginalized racial and ethnic groups.
“There's a huge emphasis on equity,” Sherin said.
“This is an investment,” he explained to the medical students gathered. “If we don't have those slots in a pipeline in the future, you're going to be in a really difficult spot, especially with the Baby Boomers and the changing demographics.”
In congressional visits, medical students also advocated reauthorization of the Conrad 30 program for noncitizen physicians, which makes targeted improvements so that rural and underserved communities continue to have access to a physician.
Learn more about the AMA’s advocacy on Conrad 30 and other visa and green-card issues, as well as the bipartisan legislation on Conrad 30 introduced in the U.S. Senate.
There’s positive momentum
Progress has been made on the issue of GME slots.
In 2021, Congress made an initial investment in shoring up the physician workforce by providing 1,000 new Medicare-supported GME positions. It was the first increase in the GME slots in 25 years. And as part of the latest omnibus bill, an additional 200 federally supported GME positions for residencies in psychiatry and psychiatry subspecialties were added.
“We are our own very best advocates, and we are the ones who can move the needle here,” Tolbert said. “While our efforts may not solve the crisis today, this can be the beginning of a long-standing discussion and eventual partnership with your lawmakers.
“If you have personal experiences that can shed light on this issue, I implore you to share them with lawmakers,” she added. “Together, we can create a brighter future for medical students and physicians alike.”
The AMA’s SaveGME.org website explains how GME funding helps resident physicians provide care to patients underserved by the health system, advance clinical research and create the future of medicine.
