AAMC Reporter: March 2007

Medical Schools Moving to Increase Enrollment

U.S. medical school enrollment will increase by 17 percent between 2002 and 2012, according to a new study from the AAMC Center for Workforce Studies.

Conducted last fall, the third annual survey of medical school deans on expansion revealed that schools are using a variety of methods to plan for increased enrollment, largely in response to evidence of a national physician shortage in coming years.

In aggregate, the study forecasts 2,558 new enrollment slots—or a 15.9 percent increase—between 2002 and 2012, with 1,880 coming from public institutions and 678 from private institutions. There are approximately 12 potential new medical schools in some phase of discussion, which account for the balance of the projected 17 percent increase.

"We are very encouraged by the progress being made on this front," said AAMC President Darrell G. Kirch, M.D. "After failing to add new capacity for 25 years, we are now responding positively to the real growth and aging of the U.S. population."

The AAMC has called for a 30 percent increase in first-year U.S. medical school enrollment by 2015. In 2002, U.S. medical schools reported 16,488 matriculants. Based on the survey, center personnel expect that number will grow to nearly 19,300 by 2012. The expected increase primarily reflects enrollment growth at existing medical schools, with three-quarters of existing schools indicating a likelihood of some increase. While several new medical schools are expected to open in the next five years, new enrollment generated by those schools will not have a major impact by 2012.

Compared to their 2005-06 enrollment, 58.6 percent of the 121 schools that responded to the survey plan to raise their enrollment, including 64 schools with plans to increase their first-year enrollment by five or more students by the 2011-12 academic year. Forty percent of these enrollment increases would be equal to or in excess of 10 percent of the current enrollment. Of the schools with plans to increase enrollment, seven plan to raise their enrollment by more than 50 students in the next five years, with two schools indicating plans for enrollment growth of more than 100 first-year students. Fifty-one schools expect enrollment to remain unchanged or plan an increase of fewer than five students by 2011-12; six schools indicated they plan to decrease their first-year enrollment over the next five years. The six schools with planned decreases in first-year enrollment expect these decreases to fall in the range of one to 12 students over the next five years.

Existing schools are employing a variety of methods to widen their capacity.

"U.S. medical school expansion has occurred through a variety of mechanisms, including expansion of an existing campus, new regional or branch campuses, and new clinical affiliations," according to the report. Of these options, 52 schools reported "definite" or "probable" plans to enter into new clinical affiliations, while 40 schools reported "definite" or "probable" plans to expand their existing campus and 18 schools indicated "definite" or "probable" plans to add a new regional or branch campus. Several other schools stated that they plan to increase joint or dual-degree programs as a mechanism to boost first-year enrollment.

Several tangible changes have already begun to take place on many campuses as well. According to the study, 42 schools have constructed new teaching space and/or reconfigured existing space, 40 have developed new teaching or curriculum methods and practices that accommodate increased enrollments, 23 have already hired new faculty, and 11 have hired consultants to conduct studies or analysis related to expansion. In addition, 15 schools have obtained more state funding for expansion. Other expansion activities reported by the schools include a variety of in-depth analyses of financial impacts and potential applicant pools, the implementation of admissions retreats to discuss ideas, and new task forces to review expansion.

"These activities show that medical schools are undertaking potential expansion with due diligence to ensure that proper academic infrastructure and resources, including potential students, are sufficient for increased enrollment," the report stated.

Deans reported several barriers—including a lack of classroom space, ambulatory preceptors, and general costs of expansion and scholarships—which continue to hinder expansion.

Compounding the "major" expansion barriers of limited scholarship availability, classroom space, and ambulatory preceptors that were specified by many medical schools, less than 10 percent of respondents reported a lack of basic science faculty, numbers and/or variety of patients, regulatory/accreditation requirements, or quality of applicants. Many of the schools that indicated "major" barriers to expansion also reported that their expansion plans are only "probable" or "possible."

Medical school expansion will be discussed in greater detail at the Third Annual AAMC Physician Workforce Research Conference, to be held May 2-4 in Bethesda, Md.

—By Scott Harris

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