Today is Match Day 2024 for recent medical school graduates hoping to snag the residency program of their choice. This week the National Resident Matching Program (Match) informed 50,413 medical school graduates whether they matched to their preferred program or have to wait another year (or give up).
Imagine spending eight years after high school studying for your dream career. You volunteer at your church, local soup kitchens and even volunteer at a community hospital to better your chances of getting into medical school. Medical school admissions are competitive and expect prospective applicants to engage in extracurricular activities that help the community. After college you apply to every medical school you can think of. If you can’t get into a (cheaper) state school, you apply to more expensive private medical schools. Some people even apply to schools in the Caribbean or other countries. In addition to your time and effort, you sink hundreds of thousands into debt to complete your medical education.
When you graduate, you’re not free to practice medicine yet. You must apply for graduate medical education (GME) training programs that are required in all 50 states before you can get a license to practice medicine. Then you discover there are training slots for only about 80% of those who apply. The remaining 20% may never be allowed to practice medicine. If this sounds impossible, it’s not. It happens every year in March. It happened this year too.
About 10,000 medical school graduates were disappointed this year when they opened their letters telling them they did not match to a residency. Many of these will never match to a residency and never be allowed to practice medicine in the US.
In 2024 there were 50,413 medical school graduates registered for the Match, hoping to be accepted to a residency program. The problem is that there are only 38,94 1st year residency slots to match with an applicant. There are a couple thousand positions that will be offered though a supplemental match and a few applicants seeking 2nd year slots. However, about 10,000 medical school graduates will have to try again next year. The reality is that most of these will never match and never care for American patients.
Residency lasts three to seven years depending on the specialization. Want to be a surgeon? That requires surgical residency. Want to be a dermatologist? That’s a dermatology residency. Some graduates don’t match because there were better candidates competing for a coveted specialty. Sometimes graduates’ preferences were too narrow, say, they only wanted a dermatology residency in a popular, sunny location near family. Others fail to match because they chose a specialty with too few residency slots. Mostly, thousands of medical school graduates don’t match because there just aren’t enough residency slots to meet demand.
Congress capped the number of GME residencies Medicare can fund back in 1997, after the American Medical Association convinced Members of Congress there was going to be a glut of physicians in the future. This self-serving lobbying resulted in a massive physician shortage in the United States. That was always the goal, of course. The Association of American Medical Colleges estimates the United States has a shortage of around 20,000 physicians today. This shortage is expected to increase by an additional 100,000 physicians in 10 years as aging physicians retire. This means the shortage next year will be 30,000 and 40,000 the year after that and so on. Now you know why it’s tough to find a primary care physician and why it will get much worse as aging Baby Boomers retire and need more care.
Congress recently authorized funding for 1,000 more residency training positions, but that’s something of a misnomer. Most of the funding will be for students in their second, third or later year of training, so it really only increases the physician supply by a few hundred additional physicians graduating annually. Most students stay and practice medicine in the state where they trained so a few states have added residency funding to the total but it’s not enough to alleviate the shortage. That still leaves us between 5,000 to 10,000 residency positions short of the number we need.
A small number of states currently allow medical school graduates, who have not matched to a residency, to work under a licensed physician as an assistant physician or associate physician. This is a good idea, but there are too few physicians willing to train assistant physicians. In addition, some of these programs severely limit the number of years assistant physicians can work under a licensed physician. In those states the goal is to better prepare assistant physicians to obtain a residency slot (that they may never obtain). These programs should instead work to integrate assistant physicians into the health care workforce through on-the-job training and mentoring.
The U.S. has an excess of medical school graduates who would like to practice medicine but may never be allowed to. State lawmakers need to seek out ways to put these medical school graduates to work treating patients. There are too many Americans who lack access to care and a medical school graduate is a terrible thing to waste.
More about the National Resident Matching Program
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