Imagine you, like most traditional medical students, went to college for four years to earn an undergraduate degree. Like many, you might also have obtained a graduate degree or worked for a period of time. You then spend time and money fulfilling extracurricular activities, taking the Medical College Admission Test (MCAT), applying to schools and traveling for interviews. If you are part of the lucky minority — roughly 40 percent — you will gain entrance to a medical school to spend four more years and tens of thousands of dollars to graduate as a physician.
Imagine you do all this, only to find you have no job.
Jobless doctors? At one point, that would have been preposterous, but just last year more than 500 MD graduates in the United States did not obtain residency positions. This total does not include the thousands of osteopathy students and international medical students who were not matched. According to the National Resident Matching Program, the organization that matches allopathic medical students with their graduate medical training sites, more than 13,000 applicants were unmatched in the initial process and participated in a supplemental program instead. In all, 34,355 U.S. and international medical students were competing for 26,392 positions.
This seems like an interesting predicament for a country that fears an imminent physician shortage. By some estimates, the United States will be short more than 60,000 physicians in the next two years. This is also devastating to students. Without a residency position, you cannot practice medicine and therefore cannot earn a living. That is scary news to the average medical student who graduates with more than $160,000 in debt.
At this point you might be wondering what the problem is. Where is the hang up in the system we trust to train an adequate physician workforce? There are actually several problems, all of which come down to the funding of graduate medical education, or GME. GME funding is directly tied to Medicare and indirectly tied to Medicaid. Anything that affects Medicare and Medicaid will invariably affect residency training positions.
