New Schools, Increased Class Sizes Boost U.S. Medical School Enrollment

First-year enrollment at the nation's medical schools grew again in 2009 because of the launch of four new schools in Florida, Texas and Pennsylvania, as well as notable expansions in class sizes at a dozen more schools, according to the Association of American Medical Colleges, or AAMC. Despite the increases, however, one workforce expert says that the country's critical need for more family and other primary care physicians can't be met if family medicine residency programs continue to close.

"Medical school expansion is not going to help the nation's physician workforce problems if we continue to produce the wrong kinds of doctors who continue to practice in the wrong areas," said Perry Pugno, M.D., M.P.H., director of the AAFP Division of Medical Education.

In an Oct. 20 press release, the AAMC said first-year enrollment in U.S. medical schools increased by 2 percent compared with 2008 -- to 18,390 students this year.

A big portion of the increase comes from the opening of four new medical schools: Florida International University Herbert Wertheim College of Medicine in Miami, the University of Central Florida College of Medicine in Orlando, Texas Tech University Health Sciences Center Paul L. Foster School of Medicine in El Paso and The Commonwealth Medical College in Scranton, Pa.

In addition, according to the AAMC, 12 existing medical schools (6-page PDF; About PDFs) increased their first-year class sizes by 7 percent or more, led by the University of Missouri-Kansas City School of Medicine in Kansas City, Mo., at almost 21 percent; Tufts University School of Medicine in Boston at more than 12 percent; and Rush Medical College of Rush University Medical Center in Chicago at almost 11 percent.

The AAMC also reported some increases in racial and ethnic diversity among enrollees. For example, this year's entering class had the largest number of black enrollees at 1,312 students, or 7 percent of total enrollment -- the largest number since 1999, according to the AAMC. The number of Asian enrollees also was up by about 4 percent to 4,114.

The number of Hispanic/Latino enrollees dropped slightly, however, compared with 2008, as did the number of American Indian enrollees.

But even as the overall number of first-year medical students continues to grow, the number of family medicine residencies is declining. According to Pugno, 30 family medicine residency programs closed from academic year 2003-04 through 2007-08.

"We need to correct the primary care shortage by producing more family physicians. We can't do that as long as we're losing family medicine training programs because of inadequate financial support, crushing bureaucratic overhead and a disproportionate burden of providing uncompensated care," he said.

Medical school expansion and GME funding are addressed in the Academy's new policy on family physician workforce reform. The policy's recommendations include establishing a national commission to develop a plan to align GME policy with the country's needs, creating a public-private entity to allocate funding for GME positions, and ensuring that medical school expansion targets primary care in rural and underserved areas.

"Unless the GME 'caps' are lifted for family medicine and primary care, we will not be able to expand our pool of graduates to serve the nation's needs," said Pugno. "Even that won't help unless we can positively impact student interest in primary care careers. Reimbursement for primary care services is a major variable in that question."