Every March, the blood pressure of fourth-year medical students begins to rise. With Match Day fast approaching – this year landing on March 17 – students reflect on the carefully crafted strategy behind their residency program applications, interviews and subsequent rankings. They try to disregard the stories they've heard about not matching. During this time, it's understandably easy to subscribe to the notion that there aren't enough residencies to go around and that inevitably there will be an overflow of applicants stranded in professional limbo. Medical and pre-med students alike should be relieved to hear that's simply not true. According to data analysis published by The New England Journal of Medicine, the number of medical graduates has indeed begun catching up with the number of available residency positions, but the gap is narrowing very slowly. The report examined recent and projected U.S. medical school enrollment alongside the rate of increase in residency program positions, concluding that in 2024 the inventory of available residency slots will still exceed the number of U.S. medical school graduates by around 4,500. It's easy to deduce where the notion of a residency shortage took root, as not all residency positions are equally competitive. Students who are interested exclusively in the trifecta of highly competitive specialties in the most prestigious programs located in metropolitan cities do indeed discover that there are more applicants than there are seats. It is imperative, however, that both students and the academic leaders who counsel them recognize the opportunity that exists to serve the most acute healthcare needs of the country. The Association of American Medical Colleges (AAMC) forecasts a physician shortage as great as 94,000 doctors by 2025. But this shortage is not evenly dispersed across geographies or specialties. The need is most severe within primary care and in rural and diverse urban neighborhoods. According to the AAMC, our country is already grappling with a deficiency of 8,200 primary care physicians. In a country with such need of physicians, it is critical that the industry stop burdening students with this false residency anxiety – even frightening some pre-med students away from the field entirely. Instead, medical professionals and educators must do a better job of encouraging and fostering an interest in meeting the country's need for doctors who care for the underserved and specialize in primary care. While competition grows among specialties, residency slots in primary care are steadily increasing and have grown 2%-3% on average each year. Drawing on my experience as a family medicine doctor, I have made a concerted effort throughout my career in academia to create an environment that celebrates these pursuits – first at the University of Kansas School of Medicine and now at American University of the Caribbean School of Medicine (AUC). I have seen the powerful effect of surrounding a class of medical students with educators whose backgrounds are in primary care and of placing them in circumstances where they gain experience caring for the neediest patient populations. AUC students, for example, complete clinical training in communities like Detroit, New York and Miami, where hospitals and health systems are challenged by health professional shortages compounded with high numbers of uninsured and underinsured patients. We expose our medical students to healthcare challenges early on so they can carry these experiences into their professional careers. They are also connected with practicing graduates throughout their education in order to explore the numerous options available within primary care. In any conversation about residency placements, Caribbean schools often get lumped into one category without accounting for sharp differences in quality. Some schools lead the international group by far, and mine was among those recently profiled in STAT News for the quality of MD graduates placing into U.S. residency programs. We work to ensure that our graduates possess the knowledge and skills that residency program directors are looking for. This means enhancing our students' preparation for licensing exams, ramping up student advising, and pairing students with physician mentors who can advise them on how to prepare for the residency match -- all of this while surrounding our students with a learning environment that combines high-tech systems with high-touch student support. Many of my school's graduates go on to become primary care physicians or to care for underserved populations – and some do both. AUC graduates also go into specialties as diverse as neurology, radiology, and anesthesiology. They do so across the nation; last year, 88.5 percent of AUC's first-time eligible graduates matched into residency programs in 37 states. My point is that those medical graduates could go there because opportunity continues to beckon. Residencies are not running short, and no one should let themselves be dissuaded from a medical career by baseless rumors of a bottleneck. Heidi Chumley, MD, is Executive Dean and Chief Academic Officer of the American University of the Caribbean School of Medicine. Source
