Skip to Content

What We Do Matters

What we do matters

Since 1876, the AAMC has offered services, products, and resources to help tomorrow’s doctors.

AAMC Learning Center

Hold your next Washington D.C., event at the AAMC Learning Center. Our staff will help you plan a memorable experience.

A Word From the President: Ignoring the Doctor Shortage at Our Peril

AAMC Reporter: April 2015

Last summer, at the Aspen Ideas Festival Spotlight Health, I participated in a debate titled “Is There a Doctor Shortage?” The conversation focused on the number of doctors we will need in the next decade, geographic and specialty distribution, and decisions at the educational level that have an impact on both. I presented AAMC evidence for a serious physician shortage—driven in particular by a growing and aging population that will lead to a significant increase in demand for health care services in the coming decade. My debate partner’s counterargument was that there is no shortage, and we can solve the problem of physician supply by targeting certain specialties for increases, de-emphasizing others, shifting tasks to nurse practitioners and physician assistants, and otherwise ridding the system of inefficiencies. 

In hindsight, it is unfortunate that the discussion was framed as an “either/or” proposition, given the complexity of health care trends. In fact, I agree with many of the changes suggested by my debate partner. Our health care system is in a transformational moment, and we indeed should seize the opportunity to develop better practice models, create a culture of team-based care, and focus on developing a diverse health care workforce that serves all Americans. However, we also face a host of challenges: The forces that resist change in this country are intense, and our government is in a state of gridlock. Ridding our health care system of complications and inefficiencies will not be a simple process. Meanwhile, 10,000 baby boomers turn 65 every day, and by 2020, one-third of currently practicing physicians plan to retire. The physician shortage is already upon us, and all the evidence indicates that it will get worse in the next decade. 

To settle the debate, the AAMC undertook a rigorous effort over the past year to update its physician workforce projections. We engaged the services of an independent firm, IHS Inc., to perform a broad national analysis that takes into account both shifting demographics and ongoing changes to care delivery and payment methods. The new study, released last month, includes more variables than past studies: What will be the impact of expanded insurance coverage under the Affordable Care Act? What are the potential implications of greater use of integrated care delivery models, such as patient-centered medical homes, accountable care organizations, and non-physician clinicians? What will be the effect of new developments in technology and emerging trends in primary care? Our goal was to examine every realistic health care delivery and policy scenario to provide the best possible predictions of what the future of health care may hold. 

Because of the many unpredictable variables in the health care landscape, we made the key decision to present our findings in ranges that account for a variety of outcomes. The study found that under every likely scenario the United States will face a shortage of between 46,000 and 90,000 physicians by 2025. With shortages projected for both primary and specialty care, the study revealed especially serious shortages for the kind of medical care our aging population will need. 

Solving the shortage will require a multi-pronged approach, including continuing to develop more efficient ways to deliver care. We also must train more doctors—at least 3,000 each year—if we are going to meet the needs of our population. While medical schools have done their part and are graduating more students than ever before, we will not add more physicians to the workforce until Congress lifts the cap on the number of residency positions supported by the federal government that has been frozen since 1997. An additional 3,000 doctors would not close the gap entirely, but it would significantly alleviate the shortage.

The implications of the congressional cap on residency training slots played out just a few weeks ago on Match Day. At medical school campuses across the country, Match Day is a time for celebration and the sense of excitement is palpable as students discover where they will be completing their residencies. Many students had reason to celebrate as they moved one step closer to achieving their dreams of becoming practicing physicians. However, with more applicants than ever applying for U.S. residency positions, some students once again failed to match to a residency program. This year, 1,093 U.S. seniors initially went unmatched. Many entered the post-Match Supplemental Offer and Acceptance Program (SOAP), competing with 7,547 other unmatched applicants for only 1,041 unfilled first-year residency positions. While some found positions through SOAP, other fully educated doctors who have earned their MDs have no immediate pathway to continue their physician training.

Failure to match is a complex problem, affected by the decisions that schools make in the design of their programs and by the choices that individual students make in medical school and their residency applications. However, with nearly 35,000 U.S. and international medical graduates vying for approximately 27,000 first-year positions, no amount of curriculum design or student coaching will create enough residency positions. Only Congress can do that. Considering the significant physician shortage that we face over the next decade, it is essential that every newly graduated MD be able to continue his or her residency training if our nation is to avert a serious crisis.

As a new graphic novel-style video from the AAMC explains, the doctor shortage “is coming. It matters. It’s time to act.” More efficient models of practice and delivery will help, but the demographics are undeniable. We need more physicians. As we saw during the VA health care crisis last year, the first people affected by the physician shortage will be the most vulnerable. But this shortage ultimately will affect us all. Congress must act now to ensure we have enough doctors to serve the health of our communities now, in 10 years, and beyond. Our national problem will only deepen if we wait any longer. Do we really want to roll the dice, taking chances with the health of our nation?

Editor’s Note: To view “The American Doctor Shortage,” a new graphic novel from the AAMC, go to