Filling the classroom

Medical school enrollment reaches target.

By Melanie Wolkoff Wachsman

Back in 2006, the Association of American Medical Colleges (AAMC) Center for Workforce Studies in Washington, D.C., responded to concerns of a likely physician shortage. The AAMC recommended a 30 percent increase in U.S. medical school enrollment by 2015.

Using the 2002-2003 first-year enrollment of 16,488 students as a baseline, this would lead to an increase of 4,946 students for a total of 21,434 students by 2015.

This goal could be met, the AAMC said, by increasing enrollment at existing medical schools and, where appropriate, creating new medical schools. The AAMC also recommended ongoing monitoring of the supply and demand for physicians in order to continue to provide guidance to the medical education community.

Projected Growth
Fast-forward to 2013. Have U.S. medical schools reached their goal?

Yes, in fact, U.S. medical schools are on track to increase their enrollment 30 percent by 2017, according to results of the annual Medical School Enrollment Survey conducted by the AAMC. Further, first-year medical school enrollment is projected to reach 21,434 in 2017-18. This number represents a 30 percent increase above first-year enrollment in 2002-03, the baseline year used to calculate the enrollment increases that the AAMC called for in 2006.

“We’re pleased to see our nation’s medical schools increasing enrollment to address the projected physician shortage,” said AAMC president and CEO Darrell G. Kirch, MD, in a news release. “But as we saw in the results of this year’s match, Congress now needs to do its part and act quickly to increase the number of federally funded residency training positions in order for all medical school  graduates to be able to complete their training and become practicing physicians.”

Of the projected growth in medical school enrollment between 2002- 2017, 62 percent will occur in the 125 medical schools that were accredited as of 2002. New schools since 2002 will provide 31 percent of the growth, and seven percent will come from schools that are currently applicant or candidate schools with the LCME (Liaison Committee on Medical Education).

More than half (55 percent) of the 4,946 new positions projected by 2017 are expected to come from public medical schools, with the greatest growth occurring in the Southern region, where schools account for a striking 46 percent of the increase between 2002 and 2017.

Residency Positions Lacking
However, survey results show that the adequacy of clinical training opportunities for students may pose a challenge for medical schools. Seventy-eight percent of respondents expressed concern about the number of clinical training sites for students, 82 percent about the supply of qualified primary care preceptors, and 67 percent about the supply of qualified specialty preceptors.

The survey also found that 40 percent of the medical school deans surveyed expressed “major concern” about enrollment growth outpacing growth in the number of available residency training positions, also known as graduate medical education (GME). Thirty-three percent of schools reported this as a “major concern” in their state and 42 percent as a “major concern” at the national level.

Only 14 percent of schools reported “major concern” about their incoming students’ ability to find residency positions of their choice after medical school. The level of concern did not show any pattern by public/private status, region or other school characteristics.

According to data collected since 1984, the 2013 match marked only the second time there were more unmatched U.S. seniors than unfilled positions; the first time was 2010.

Primary Care Initiatives
The survey also asked respondents to report difficulties with their existing clinical training sites, such as challenges with volunteer physicians, competition from other schools or payment pressure.

Schools reported statistically significant increases in competition from osteopathic medical schools for clinical training sites and competition from other healthcare professionals such as nurse practitioners and physician assistants.

Osteopathic enrollment continues to rise rapidly with new first-year enrollment in 2017-2018 expected to reach 6,675 (This represents a 125 percent increase from first-year enrollment in 2002-2003.).

Combined first-year MD and DO enrollment at current medical schools is projected to reach 28,109 by 2017-2018. That is an increase of 44 percent when compared to 2002-2003. Of that growth, 43 percent will come from osteopathic schools.

Specialist Needed
While medical school enrollment increases helps address the upcoming physician shortage overall there still is a concern over the shortage of primary care specialist.

According to the survey seventy-six percent of schools said they had either established or recently implemented at least one initiative to increase student interest in primary care specialties.

These efforts included changes in curriculum, extracurricular opportunities, expanded faculty resources and training, and changes in admissions criteria.