The United States is facing a serious shortage of physicians, largely due to the growth and aging of the population and the impending retirements of older physicians. While medical schools continue to increase enrollment, the number of residency trainings effectively has not increased — thanks to the 1997 cap on Medicare support for graduate medical education (GME).
Fixing the doctor shortage requires a multipronged approach, including innovations such as team-based care and better use of technology. It also needs to include lifting the cap on federally funded residency training positions. While not every residency training is funded through Medicare, cuts to it and other clinical reimbursements jeopardize the ability of teaching hospitals to cross-subsidize with clinical revenue.
In addition, the AAMC supports non-GME incentives and programs, including Conrad 30, the National Health Service Corps and Public Service Loan Forgiveness, and Title VII/VIII, which are used to recruit a diverse workforce and encourage physicians to practice in shortage specialties and underserved communities.
Doctor shortages pose a real risk to patients. A study conducted for the AAMC by IHS Inc., predicts that by 2033, the United States will face a shortage of between 54,100 and 139,000 physicians. This includes primary care, as well as specialty care — where the shortage is expected to be particularly large.
Legislation to Address the Physician Shortage
Addressing the doctor shortage requires a multi-pronged approach, including increasing federal support for GME, which has remained effectively frozen since 1997. The AAMC supports the Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763), which would add 15,000 residency slots over five years.
The Opioid Workforce Act of 2019 (H.R. 3414, S. 2892) would provide Medicare support for an additional 1,000 GME positions over the next five years in hospitals that have, or are in the process of establishing, accredited residency programs in specialties needed to respond to the opioid epidemic.
State-by-State Graduate Medical Education Data
All medical school graduates must complete a period of GME, or residency training, to be licensed to practice medicine in the United States. GME comprises the second phase — after medical school — of the formal education that prepares doctors for medical practice. During residency, doctors learn skills and techniques specific to their chosen specialty under the supervision of attending physicians and serve as part of a care team.