AAMC 2012 Survey Highlights Dilemma in U.S. Medical Education

Medical School Enrollment Outpacing Available Residency Slots

May 20, 2013 02:47 pm Sheri Porter

New survey results released by the Association of American Medical Colleges (AAMC) show that enrollment at U.S. medical schools and schools of osteopathic medicine continues to increase at a steady pace. However, the same survey report highlights increasing concern from the nation's medical school deans about insufficient numbers of residency training positions being available to meet matriculating students' graduate medical education needs.

[Stock photo of older physician with medical students]

The report, "Results of the 2012 Medical School Enrollment Survey(members.aamc.org)," was prepared by the AAMC's Center for Workforce Studies and represents the ninth iteration of the annual effort.

Specifically, first-year medical school enrollment is projected to reach 21,434 by the 2017-18 school year, which is a 30 percent increase compared to 2002 enrollment numbers. The report projects an even sharper increase in osteopathic medical school enrollment; first-year enrollment is expected to reach 6,675 in 2017, which represents a 125 percent increase since 2002. Combined first-year M.D. and D.O. medical school enrollment likely will reach 28,109 by 2017 compared to 19,456 in 2002.

In an AAMC press release(www.aamc.org), AAMC President and CEO Darrell Kirch, M.D., says he is pleased to see medical school enrollment increasing at a time when many health care analysts are predicting severe physician shortages. But, he adds, Congress needs to increase the number of federally funded residency training positions.

Story Highlights
  • Results of the 2012 AAMC medical school enrollment survey show that first-year enrollment at U.S. medical schools and schools of osteopathic medicine is increasing.
  • Medical schools are implementing policies and programs to increase medical student interest in primary care specialties.
  • Increasingly, medical schools are worried about clinical training opportunities for students.

"Increasing enrollments show that medical schools are doing their part to avert the shortage of more than 90,000 primary care specialty doctors this nation faces by 2020," says Kirch. "However, this will not result in a single new practicing physician unless Congress acts now to lift the cap on residency training positions."

The AAMC points out there were more U.S. seniors seeking residency positions in the recent 2013 National Residency Matching Program than there were residency spots available. The same situation occurred in 2010.

Focus on Primary Care

Authors of the AAMC's survey summation report also highlight the country's primary care dilemma and note that "amid expected shortages of primary care physicians, schools are implementing policies and programs designed to encourage student interest in primary care."

Indeed, survey results show that 76 percent of schools already have instituted, or are planning to institute, at least one primary care initiative to increase student interest in primary care specialties. These efforts include refined admissions criteria, changes in curriculum and extracurricular opportunities, expanded primary care faculty resources and training, and implementation of financial incentives, such as tuition or debt reduction.

In its 2010 survey, the AAMC asked schools for the first time about plans to stir student interest in primary care. At that time, 46 schools said they planned to establish initiatives within two years. However, 2012 survey results show that only about one-third of those schools met that goal.

Still, the survey authors express optimism that interest in creating primary care initiatives is ongoing. "While comparison of past survey results with those of this year show that plans to implement such initiatives do not necessarily come to fruition within a two-year window, 38 percent of schools have plans for the next two years," say the authors.

Additional Survey Highlights

According to the 2012 report, the projected 30 percent increase in first-year medical school enrollment "matches exactly the 2015 target recommended by the AAMC in 2006."

The 2012 survey also indicates that of the 4,946 new positions projected by 2017, 55 percent are expected to come from public schools and 45 percent from private schools. In addition,

  • 46 percent of the additional students will be enrolled in schools in the southern region of the United States,
  • 22 percent will be enrolled in the central region, 
  • 19 percent will be enrolled in the northeast region and
  • 13 percent will be enrolled in the western region.

Medical schools also indicated growing concerns about clinical training opportunities for students. For example,

  • 78 percent of schools surveyed in 2012 were worried about the number of clinical training sites compared to 65 percent in 2011,
  • 82 percent expressed concerns about the supply of qualified primary care preceptors compared to 74 percent in 2011, and
  • 67 percent were troubled about the supply of qualified subspecialty preceptors compared to 53 percent in 2011.

Survey respondents also reported more difficulties with existing clinical training sites, including high turnover among physician volunteers; difficulty in replacing retired physician volunteers; pressure from existing clinical training sites regarding payment for student rotations; and competition from osteopathic medical schools, offshore medical schools, and other health care professionals, such as nurse practitioners and physician assistants, for clinical training sites.

Lastly, of the projected growth in medical school enrollment between 2002 and 2017, the survey found 62 percent will occur in the 125 medical schools that were accredited as of 2002. Another 31 percent will occur in schools accredited since 2002, and 7 percent will come from schools that currently are applicant or candidate schools with the Liaison Committee on Medical Education.