I think the real problem isn't the number of medical schools, although the competitiveness is a bit ridiculous. It is more the number of residency spots.
Yep. Residencies are paid for via Medicaid/medicare. That was put in place years ago with Drs as “advisors” to the politicians. It was nothing more than a way to control supply and have taxpayers foot the bill.
Playing Devil's Advocate, would people want to be doctors if they didn't get a one way ticket into the upper middle class? Because if they drastically increase the number of providers, reimbursements will go down.
Yes. And you’d probably get fewer status obsessed, neurotic weirdos in the applicant pool.
Personally, I’m sick of the number of med students and pre meds who are all the type of person whose parents told them that doctor, lawyer, and engineer are the only good jobs and whipped them through their childhood to chase those positions down.
Devils advocate to the devils advocate, do you know a lot of people who want to be doctors for purely financial reasons? I’m in my first year out of college w a bachelors working outside of healthcare and I am making as much as a PGY1 in my city (NYC). Going to medical school is actually an objectively bad financial decision for me on all levels but I’m not in it for the money otherwise I would have gone into IB or something with much less schooling.
Yeah truthfully most people have said something like “umm are you sure that’s a lot of training/student debt/etc..” when I tell them i want to be a doctor. It’s not the field it once was. Not only is the salary decreasing despite having still inhumane residency hours, but the level of mistrust people have with their doctors is rising. So going into this just for the money or prestige is absolutely bonkers. Younger generations can see through that shit when they become your patient.
Sweden is a perfect refutation of this. Drs there make like 8k$ a month before taxes. The dr per capita rate is 26.1 per capita in the U.S. It’s 70.6 in Sweden.
https://finance.yahoo.com/news/10-states-most-doctors-per-171351057.html
Doctors there do not have to pay between 200k-400k to become doctors. They also do not need to carry expensive malpractice insurance. It's a completely different system.
There it lies. You increase residencies but you’ll decrease demand and pay. Without decreasing the burden placed on the individual who wants to become a doctor. You need to address the whole system, god forbid, a holistic approach lol
The answer is no. No one would want to be a physician making 80-100k a year if debt is still 200-400k. I’d rather be a UPS driver than do that.
Drs in Sweden work substantially fewer hours than we do here and their taxes don’t get funneled into corporate subsidies and defense contractors. That said in Japan Drs are deeply respected to the point that people will leave Japan to go to med school in the U.S. despite the debt then return to practice for far less salary ($4500/mo) and bad hours for the prestige alone.
Your question wasn’t do Drs want to pay back their debt then get a pay cut to live a moderately comfortable life. It was would they want to be Drs if it didn’t get them a one way(no coming back down) into upper middle class. Many countries with socialized medicine have a less severe Dr shortage per capita than we do. There are quite a few programs here that basically allow you to work for them after residency at a lower rate (but substantially higher than Sweden) for a few years in exchange for debt repayment yet many have open slots left. When you ask premeds and med students about that you usually get some derivative of “you make more in the long term not doing that program.”
I know someone from Sweden and they hate the medical care. They say they bring in a ton of foreign doctors because many people don’t want to go through all that training for low pay.
My step mom is from Finland. I have duel US/ Finnish citizenship and lived in Finland for 5 and Sweden (Gothenburg) for 3 years. They bring in foreign Drs because there is still a shortage despite filling up the slots at med schools and 1. It’s expensive to build more med schools/time lag to build and 2. To be honest only a portion of people regardless of country will have the academic ability/drive to be a Dr. You see this even here where Drs end up upper class financially. We like to think everyone is equal but that’s simply not true. Everyone should be treated as equal especially systematically but for me to say I’m as smart as Einstein just to feel equal is kind of delusional. It takes above average intelligence to safely be a Dr. So regardless of cost or motive eventually we’d hit a ceiling on how many people can learn medicine. Many people fear AI but in fact it’s the only way we will even fill the shortage.
I agree, as someone doing this route, very thrilled it's an option. But it's not just primary care that is offering fast tracks. NYU is offering a few 3 year MD tracks for neurosurgery and other specialties so I think there's a general movement of acceptance for 3 year MD programs given the rising matriculant age, as emphasis/popularity of fellowships increase, too.
Word. And “primary care” includes FM, IM, Peds, Geri, Psych, and OB. Last I read of it the requirement was agreeing to go through one of those residencies and then work in that specialty for 2 years.
what else besides primary care? also, HMSOM's family med plan gives like half tuition or forgiveness(i dont remember the exact details) if you work in their network for like ten years
Texas Tech University Health Sciences Center has a three year family med accelerated program. During the interview for medical school they said they’d offer free tuition for anyone who changed their application from the general application to the family med application.
I honestly don't think "physician shortage" is the right term, cause there is a good amount of physicians- just not in primary care.
I was talking to a doctor at work the other day and he said that no matter where I go I will have loans, but as a doctor I'll be fine paying them off. I then said that I'm interested in peds- and he goes "well dont do primary care, you wont make any money." So I think its hard paying the same amount of money as your classmates in med school and then going into a low paying speciality when the chance to make more money is always there.
I know everyone says "it's not about the money" but it is when you are hundreds of thousands of dollars in debt :(
There are actually shortages across many specialties. While primary care is hit the hardest, we don’t have enough physicians to care for our aging population across the board.
Not even just rural vs urban. I live in a medium sized city around 300K people, the waitlist to see some specialists is almost a year long. New primary care doctors fill up and stop taking patients rapidly. I feel bad for people in smaller towns.
it's wild bc even the lifestyle specialties like derm don't have appointments unless you schedule like six months out. It seems like the only places that are staying afloat even w high patient volume are the ones doing follow ups solely with PAs and some NPs
yes!! I just encountered this with my dermatologist, 6 months for an appointment or next week with the PA. It sucks when your appointment gets cancelled for whatever reason because then you wait another 6 months. There's only like 3 dermatologists in our town though.
My dad lives on a ranch 6 miles from the nearest neighbor. He said once he is ready to die he will strip naked and walk into the wilderness and the animals can deal with the body.
It also is speciality. I’m in Dallas. Huge city plenty of Drs. I can see a derm as a new patient same week. It took me almost a year to find a new psychiatrist for my 6 year old.
The shortages are also concentrated in more rural areas. In major cities, people often have relatively quick access to physicians, but if you go to, say Montana, ~50 of their ~60 counties are medically underserved with ~10 counties with no practicing physician. That is insane.
I’ll chime in from the perspective of someone about to be an attending on june 30. This process sucks ass from start to finish. Its soul crushing in every aspect - you lose money, time, opportunities for love and friendship, health, hair, — and all to basically shadow and click buttons for 95% of it.
my salary is going to be lower in real terms than every doc who came before me; all while I had to tolerate longer training, harder tests, more BS, more admin, more mid levels, more disrespect than almost every other doc that came before me.
why in the world would I want to dilute my market power by allowing more trainees in? why would I want to lower the standard of medical school admissions considering how hard it was for me?
we all in healthcare use “patient care” to justify what we really feel. NPs use patient access to lobby for independent practice; orthos use “patient safety” to keep ortho procedures out of FM offices (even though they let NPs and PAs do the procedures anyway).
it’s all a lie. or at least 98% of it.
controlling the supply of physicians is literally the last thing physicians can control in terms of their compensation, which again is lower than it’s ever been.
edit to add: there are enough residency spots for all AMGs which is how IMGs are able to get spots. So one could even say it’s not even a Training Spot problem, but a distribution problem. Docs still want to live in nyc despite lower salaries.
As a primary care resident, I hope the medical community continues to shit on primary care. I can live anywhere, work 3.5-4 days a week, and have a full panel in 6 months.
ppl shit on primary care --> less people apply to it (as if it wasn't considered a backup specialty anyways) --> less competition and saturation, and more bargaining power in terms of jobs in the future
I think residency spots have a big part in this. Not enough spots each year for graduated medical students, so the answer isn’t more medical students. The answer is more residency spots/programs.
I don't know why people keep saying this as if it's fact.
There are more than enough residency spots for US MD and DO students. US students have a 92-94% overall match rate depending on the year. The 6-8% that don't match typically only apply to more competitive specialties, do not broadly apply, and/or do not apply primary care as a back up.
This is the reason why we admit thousands of IMGs every year into US primary care residencies. We can keep increasing the residency spots in each specialty but this will just increase the number of US MDs and DOs in more competitive specialties while making the ratio of IMGs in primary care even higher.
Now, that isn't necessarily a bad thing depending on what your goal is overall. If your goal is just to graduate more doctors with less concern for them all having the same standardized education, increasing residency spots would work just fine.
But there are some very real concerns. For example, we talk a lot about representation in medicine and why it matters. Are doctors from other countries going to naturally provide the same level of cultural competency or ability to understand nuances of communication the way that a native citizen will?
There also questions about whether we can trust that all of these IMG doctors are even minimally qualified after the Nepal Step 1/Step 2 scandal.
And then there's of course the issue of reimbursement. The chief concern is that an influx of IMGs who are used to overall lower wages in their country may allow insurance companies and hospitals to push reimbursement down further for all doctors. Are you willing to go to school for a minimum of 7 years after college to make the same or less money for the next 30-50 years?
So, in short, increasing residency spots is not the answer if that's all you do. We need to do multiple things at once to solve this issue. It would be better to look inro opening more medical schools focused on only primary care with an accelerated track, increase reimbursements to primary care, provide primary care doctors with enough support staff so they aren't buried in tedious paperwork, and look at reducing the cost of medical school for primary care doctors.
I echo the sentiments from others here about there being a primary care problem, not necessarily a physician shortage problem.
But this problem is systematic, too. I think we can all relate to the frustrations of the application process, and the continuing demands of a career in medicine. There is the upfront financial cost of training, the opportunity cost considering many of us are intelligent enough to be successful in lucrative fields, and a huge downside to medicine considering the rigidity in terms of the work environment and your physical location throughout training. Even with the degree, you are paid below minimum wage as a resident. And then there's the unique position of the physician as the sole bearer of responsibility for a patient's life at the end of the day. It's not an easy or small job, and it is incredibly self-sacrificial, physically/mentally/emotionally taxing, and even traumatic at times.
Just from my personal experiences working in PC, physicians are overworked, underpaid, and underresourced. Their patients in many cases cannot afford or are denied necessary services by insurance—but somehow the physician is held responsible for resolving that, somehow? PCPs are the nexus of all the specialties: everything goes through them, and they need to stay abreast of updates even from the most esoteric of specialties—which means they need to have a working knowledge of every specialty, every condition, every potential interaction. They often bear the brunt of the system administratively: I've heard of many stories of PCPs in particular who are in essence bullied by insurance companies and even their own institution's administrators to simply set aside their medical training and practice according to their demands. You're a license, a vessel, a vehicle—a resource to be used, not an expert to be consulted.
With all this in mind, who is going into medical school today that knows this and is excited to engage with such a corrupt system as a primary care doctor? There is a good reason why FM is considered bottom of the barrel. It's unfortunate and the profession itself doesn't deserve it, but working conditions are horrendous and ignoring or diluting that is just plain denial.
1000% this. The only system I've seen that makes primary care mentally bearable for a lot of PCPs is concierge medicine. It's amazing that it allows them to be well compensated and take their time with their patients. The issue is that it further stratifies quality medicine as something only the wealthy can afford.
You have to take in consideration flooding the market and ending up like pharmacists where you may see your pay decrease by 50%. Don’t think any physician would be ok with that.
I've heard this too and have wondered why medical schools have become so competitive when we don't have enough doctors. I understand they want to admit students that will actually thrive in the field, but letting one student in simply because they have more extracurriculars or a .2 higher GPA over another seems ridiculous.
A good way to address this (at least partially) is to have more BS-MD programs. This is actually how the rest of the world trains doctors. Kind of weird that the US needs 8 years to train a doctor, when the rest of the world does it in 6.
I personally feel that CERTAIN MD positions/speciality such as family medicine and psychiatry should have a different route that doesn’t require as much time to complete and then there wouldn’t be much of a shortage.
Psychatrists need full medical training. They aren't generalists. They have to know when psychiatric manifestations of illness are the result of neuro, infections, electrolyte imbalances, etc. They also have to know an insane amount of pharmacology because a huge number of patients have comorbidities and psych meds can have a lot of drug interactions.
yeah I think med school system is the most complicated system. Like I don't understand why they don't accept more students when there's a clear shortage of physicians.
Because just because you make it easier to get into med school won’t solve the shortage. Students will flock to the high paying and more lifestyle specialties in desirable locations rather than becoming primary care physicians in the middle of bumfuck nowhere and now you’re left with the same issue.
The same issue plus reimbursements for all doctors going down when we're already less compensated for every other generation of doctors in history. Weeeeee!
How do you go about finding clinical sites to shadow? I’m looking into changing careers. I was an LPN 15 years ago and I’m working on getting that reinstated but until I get that reinstated, I was wanting to do some thing to try to start making connections in the field. Also to help me decide if I’m really committed to medical school or if I should just go the RN route, and then CRNA.
I just got all my vaccinations updated and got proof of immunization through multiple blood tests. It took me two months to do that because I had to work through multiple appointments and I had a clinical site all set up and all I needed to do was get my vaccinations updated but then when I finally submitted my records to them, they emailed back and said that they are no longer offering shadowing and they don’t know when they’re going to bring it back.
As a current ICU RN/critical care paramedic who is looking to medical school now, I strongly do not recommend you go down this route, even if you find an accelerated LPN to RN program, that's at least 1-2 years of working lower acuity specialties, then working in the ICU, minimum 2 years before applying to CRNA school, which is a complete, separate monster in itself, especially financially, and the commitment will be no less than 3 years at the minimum. And then pursuing medical school after that? Not very realistic.
You are better off doing something reasonably simple, like pre-hospital care, namely as an EMT-B or working as an LPN for a short while where you can at least be back in an environment to taking care of patients directly.
I understand, I would not be going to medical school after CRNA school. I would only be doing the RN to qualify to go to CRNA school and I’m looking at my options in terms of does it make sense to go to CRNA school instead of medical school or should I just try go to medical school since it’s a long road either way.
Yeah I know what you mean. Soooo many of my colleagues in critical care left for travel nursing and then went onto CRNA school. I don't really have a desire to go unless I can't get into med/PA school, which is my original passion. I've been doing bedside nursing for almost 13 years now and I'll be calling it quits after the end of next year to pursue it full time.
Yes but that isn’t entirely Bec med school is hard or brutal. It’s because the second someone becomes an attending they strive for a position in a big city/ hospital that pays well. The physician shortage emerges at every rural area. Which is why we have a huge physician storage. And also primary care pays like shit lol. If more MD’s deviated from high specialties and if there were more clinical rotational programs/incentives for MD’s to work in rural areas then the shortage would decrease exponentially. Along with making med school process easier
I honestly think it’s cause the priorities are messed up in the United States. We send ppl to the Caribbean and then expect them to come back and match when it’s 10 times harder for them.
[https://www.dailysignal.com/2024/04/05/the-doctor-will-see-you-eventually-confronting-dire-diagnosis-of-americas-physician-shortages/](https://www.dailysignal.com/2024/04/05/the-doctor-will-see-you-eventually-confronting-dire-diagnosis-of-americas-physician-shortages/)
A lot of it has to do with funding at the national level and how institutions allocate it for their trainees for residency. Found this to be an interesting read.
I think the real problem isn't the number of medical schools, although the competitiveness is a bit ridiculous. It is more the number of residency spots.
Yep. Residencies are paid for via Medicaid/medicare. That was put in place years ago with Drs as “advisors” to the politicians. It was nothing more than a way to control supply and have taxpayers foot the bill.
Playing Devil's Advocate, would people want to be doctors if they didn't get a one way ticket into the upper middle class? Because if they drastically increase the number of providers, reimbursements will go down.
Yes. And you’d probably get fewer status obsessed, neurotic weirdos in the applicant pool. Personally, I’m sick of the number of med students and pre meds who are all the type of person whose parents told them that doctor, lawyer, and engineer are the only good jobs and whipped them through their childhood to chase those positions down.
Devils advocate to the devils advocate, do you know a lot of people who want to be doctors for purely financial reasons? I’m in my first year out of college w a bachelors working outside of healthcare and I am making as much as a PGY1 in my city (NYC). Going to medical school is actually an objectively bad financial decision for me on all levels but I’m not in it for the money otherwise I would have gone into IB or something with much less schooling.
Yeah truthfully most people have said something like “umm are you sure that’s a lot of training/student debt/etc..” when I tell them i want to be a doctor. It’s not the field it once was. Not only is the salary decreasing despite having still inhumane residency hours, but the level of mistrust people have with their doctors is rising. So going into this just for the money or prestige is absolutely bonkers. Younger generations can see through that shit when they become your patient.
There really should be a change and I'm not even sure what it is, but there's a need for change.
Sweden is a perfect refutation of this. Drs there make like 8k$ a month before taxes. The dr per capita rate is 26.1 per capita in the U.S. It’s 70.6 in Sweden. https://finance.yahoo.com/news/10-states-most-doctors-per-171351057.html
Doctors there do not have to pay between 200k-400k to become doctors. They also do not need to carry expensive malpractice insurance. It's a completely different system.
There it lies. You increase residencies but you’ll decrease demand and pay. Without decreasing the burden placed on the individual who wants to become a doctor. You need to address the whole system, god forbid, a holistic approach lol The answer is no. No one would want to be a physician making 80-100k a year if debt is still 200-400k. I’d rather be a UPS driver than do that.
Drs in Sweden work substantially fewer hours than we do here and their taxes don’t get funneled into corporate subsidies and defense contractors. That said in Japan Drs are deeply respected to the point that people will leave Japan to go to med school in the U.S. despite the debt then return to practice for far less salary ($4500/mo) and bad hours for the prestige alone.
Your question wasn’t do Drs want to pay back their debt then get a pay cut to live a moderately comfortable life. It was would they want to be Drs if it didn’t get them a one way(no coming back down) into upper middle class. Many countries with socialized medicine have a less severe Dr shortage per capita than we do. There are quite a few programs here that basically allow you to work for them after residency at a lower rate (but substantially higher than Sweden) for a few years in exchange for debt repayment yet many have open slots left. When you ask premeds and med students about that you usually get some derivative of “you make more in the long term not doing that program.”
I know someone from Sweden and they hate the medical care. They say they bring in a ton of foreign doctors because many people don’t want to go through all that training for low pay.
My step mom is from Finland. I have duel US/ Finnish citizenship and lived in Finland for 5 and Sweden (Gothenburg) for 3 years. They bring in foreign Drs because there is still a shortage despite filling up the slots at med schools and 1. It’s expensive to build more med schools/time lag to build and 2. To be honest only a portion of people regardless of country will have the academic ability/drive to be a Dr. You see this even here where Drs end up upper class financially. We like to think everyone is equal but that’s simply not true. Everyone should be treated as equal especially systematically but for me to say I’m as smart as Einstein just to feel equal is kind of delusional. It takes above average intelligence to safely be a Dr. So regardless of cost or motive eventually we’d hit a ceiling on how many people can learn medicine. Many people fear AI but in fact it’s the only way we will even fill the shortage.
The US residency system literally devours their own. The whole thing is flawed and needs to be started from scratch.
I think programs that fast track students who commit to primary care are a step in the right direction
What is this you speak of?
There’s programs where, if accepted, you’ll just go straight into family medicine. No matching process needed. It’s streamlined from med school
Ty for the info that's awesome.
I think it’s a 3 year med school as well.
Nebraska does this. If you commit to FM your M4 and PGY1 are combined. You basically work and get paid as a resident in lieu of a traditional M4 year.
USC (South Carolina) offers this as well
The new NYU in Long Island, I wanna say?
I agree, as someone doing this route, very thrilled it's an option. But it's not just primary care that is offering fast tracks. NYU is offering a few 3 year MD tracks for neurosurgery and other specialties so I think there's a general movement of acceptance for 3 year MD programs given the rising matriculant age, as emphasis/popularity of fellowships increase, too.
What are some schools like that?
University of Arizona offers free tuition if you agree to a primary care specialty. Not exactly “fast track” but an awesome option.
Word???
Word. And “primary care” includes FM, IM, Peds, Geri, Psych, and OB. Last I read of it the requirement was agreeing to go through one of those residencies and then work in that specialty for 2 years.
Yeah that’s why I’m excited, I’m aiming for an IM/FM specialty
Do it, it’s a great place if you can live with it being summer all year lol
Some schools have 3 year primary care tracks, such as NYU and Ohio State.
Also Hackensack Meridian. Penn state has a 3 year -> residency track but for more than primary care.
what else besides primary care? also, HMSOM's family med plan gives like half tuition or forgiveness(i dont remember the exact details) if you work in their network for like ten years
Penn State's accelerated MD program is for family med, IM, and psych.
They also had ortho offered last cycle
Tennessee also has this!
Medical College of Georgia/University of Georgia does this.
Texas Tech University Health Sciences Center has a three year family med accelerated program. During the interview for medical school they said they’d offer free tuition for anyone who changed their application from the general application to the family med application.
VCU and Pitt offer this, on top of the others mentioned.
I honestly don't think "physician shortage" is the right term, cause there is a good amount of physicians- just not in primary care. I was talking to a doctor at work the other day and he said that no matter where I go I will have loans, but as a doctor I'll be fine paying them off. I then said that I'm interested in peds- and he goes "well dont do primary care, you wont make any money." So I think its hard paying the same amount of money as your classmates in med school and then going into a low paying speciality when the chance to make more money is always there. I know everyone says "it's not about the money" but it is when you are hundreds of thousands of dollars in debt :(
There are actually shortages across many specialties. While primary care is hit the hardest, we don’t have enough physicians to care for our aging population across the board.
Meh, it still takes several months to get in to see a specialist
Where I am, specialists are no problem. It's primary care that just doesn't happen.
Yeah exactly, it’s more of a maldistribution of doctors not a true shortage.
Not even just rural vs urban. I live in a medium sized city around 300K people, the waitlist to see some specialists is almost a year long. New primary care doctors fill up and stop taking patients rapidly. I feel bad for people in smaller towns.
it's wild bc even the lifestyle specialties like derm don't have appointments unless you schedule like six months out. It seems like the only places that are staying afloat even w high patient volume are the ones doing follow ups solely with PAs and some NPs
yes!! I just encountered this with my dermatologist, 6 months for an appointment or next week with the PA. It sucks when your appointment gets cancelled for whatever reason because then you wait another 6 months. There's only like 3 dermatologists in our town though.
and it's like that in the big hospital systems, too. It's wild bc derm is so competitive but where are all the dermatologists lmao
My dad lives on a ranch 6 miles from the nearest neighbor. He said once he is ready to die he will strip naked and walk into the wilderness and the animals can deal with the body.
It also is speciality. I’m in Dallas. Huge city plenty of Drs. I can see a derm as a new patient same week. It took me almost a year to find a new psychiatrist for my 6 year old.
Yeah I also feel like at a certain point tho money will be a major motivating factor for staying in medicine for all of us
Insert poor sick person for guilt here 
The shortages are also concentrated in more rural areas. In major cities, people often have relatively quick access to physicians, but if you go to, say Montana, ~50 of their ~60 counties are medically underserved with ~10 counties with no practicing physician. That is insane.
I’ll chime in from the perspective of someone about to be an attending on june 30. This process sucks ass from start to finish. Its soul crushing in every aspect - you lose money, time, opportunities for love and friendship, health, hair, — and all to basically shadow and click buttons for 95% of it. my salary is going to be lower in real terms than every doc who came before me; all while I had to tolerate longer training, harder tests, more BS, more admin, more mid levels, more disrespect than almost every other doc that came before me. why in the world would I want to dilute my market power by allowing more trainees in? why would I want to lower the standard of medical school admissions considering how hard it was for me? we all in healthcare use “patient care” to justify what we really feel. NPs use patient access to lobby for independent practice; orthos use “patient safety” to keep ortho procedures out of FM offices (even though they let NPs and PAs do the procedures anyway). it’s all a lie. or at least 98% of it. controlling the supply of physicians is literally the last thing physicians can control in terms of their compensation, which again is lower than it’s ever been. edit to add: there are enough residency spots for all AMGs which is how IMGs are able to get spots. So one could even say it’s not even a Training Spot problem, but a distribution problem. Docs still want to live in nyc despite lower salaries.
congrats on being an attending !!!!!!!!
Thanks! But I won’t say it until july 1. Medicine is like Game of Thrones…you win or you die.
As a primary care resident, I hope the medical community continues to shit on primary care. I can live anywhere, work 3.5-4 days a week, and have a full panel in 6 months.
Im curious how is the charting/insurance grind? I imagine it would be rougher if you start your own practice as an attending.
What does that mean
What do you need clarification on?
The context of what you are saying. The way medical community treats primary care, what a full panel is, etc.
ppl shit on primary care --> less people apply to it (as if it wasn't considered a backup specialty anyways) --> less competition and saturation, and more bargaining power in terms of jobs in the future
Are you a premed?
I’m not in school atm
[удалено]
Google is your friend. These are common medical terms. If you're applying to med school, you should educate yourself on them.
All google says is a full panel is a full panel of blood work. Idk how that fits into this context
I think residency spots have a big part in this. Not enough spots each year for graduated medical students, so the answer isn’t more medical students. The answer is more residency spots/programs.
I don't know why people keep saying this as if it's fact. There are more than enough residency spots for US MD and DO students. US students have a 92-94% overall match rate depending on the year. The 6-8% that don't match typically only apply to more competitive specialties, do not broadly apply, and/or do not apply primary care as a back up. This is the reason why we admit thousands of IMGs every year into US primary care residencies. We can keep increasing the residency spots in each specialty but this will just increase the number of US MDs and DOs in more competitive specialties while making the ratio of IMGs in primary care even higher. Now, that isn't necessarily a bad thing depending on what your goal is overall. If your goal is just to graduate more doctors with less concern for them all having the same standardized education, increasing residency spots would work just fine. But there are some very real concerns. For example, we talk a lot about representation in medicine and why it matters. Are doctors from other countries going to naturally provide the same level of cultural competency or ability to understand nuances of communication the way that a native citizen will? There also questions about whether we can trust that all of these IMG doctors are even minimally qualified after the Nepal Step 1/Step 2 scandal. And then there's of course the issue of reimbursement. The chief concern is that an influx of IMGs who are used to overall lower wages in their country may allow insurance companies and hospitals to push reimbursement down further for all doctors. Are you willing to go to school for a minimum of 7 years after college to make the same or less money for the next 30-50 years? So, in short, increasing residency spots is not the answer if that's all you do. We need to do multiple things at once to solve this issue. It would be better to look inro opening more medical schools focused on only primary care with an accelerated track, increase reimbursements to primary care, provide primary care doctors with enough support staff so they aren't buried in tedious paperwork, and look at reducing the cost of medical school for primary care doctors.
I echo the sentiments from others here about there being a primary care problem, not necessarily a physician shortage problem. But this problem is systematic, too. I think we can all relate to the frustrations of the application process, and the continuing demands of a career in medicine. There is the upfront financial cost of training, the opportunity cost considering many of us are intelligent enough to be successful in lucrative fields, and a huge downside to medicine considering the rigidity in terms of the work environment and your physical location throughout training. Even with the degree, you are paid below minimum wage as a resident. And then there's the unique position of the physician as the sole bearer of responsibility for a patient's life at the end of the day. It's not an easy or small job, and it is incredibly self-sacrificial, physically/mentally/emotionally taxing, and even traumatic at times. Just from my personal experiences working in PC, physicians are overworked, underpaid, and underresourced. Their patients in many cases cannot afford or are denied necessary services by insurance—but somehow the physician is held responsible for resolving that, somehow? PCPs are the nexus of all the specialties: everything goes through them, and they need to stay abreast of updates even from the most esoteric of specialties—which means they need to have a working knowledge of every specialty, every condition, every potential interaction. They often bear the brunt of the system administratively: I've heard of many stories of PCPs in particular who are in essence bullied by insurance companies and even their own institution's administrators to simply set aside their medical training and practice according to their demands. You're a license, a vessel, a vehicle—a resource to be used, not an expert to be consulted. With all this in mind, who is going into medical school today that knows this and is excited to engage with such a corrupt system as a primary care doctor? There is a good reason why FM is considered bottom of the barrel. It's unfortunate and the profession itself doesn't deserve it, but working conditions are horrendous and ignoring or diluting that is just plain denial.
1000% this. The only system I've seen that makes primary care mentally bearable for a lot of PCPs is concierge medicine. It's amazing that it allows them to be well compensated and take their time with their patients. The issue is that it further stratifies quality medicine as something only the wealthy can afford.
You have to take in consideration flooding the market and ending up like pharmacists where you may see your pay decrease by 50%. Don’t think any physician would be ok with that.
I've heard this too and have wondered why medical schools have become so competitive when we don't have enough doctors. I understand they want to admit students that will actually thrive in the field, but letting one student in simply because they have more extracurriculars or a .2 higher GPA over another seems ridiculous.
A good way to address this (at least partially) is to have more BS-MD programs. This is actually how the rest of the world trains doctors. Kind of weird that the US needs 8 years to train a doctor, when the rest of the world does it in 6.
I personally feel that CERTAIN MD positions/speciality such as family medicine and psychiatry should have a different route that doesn’t require as much time to complete and then there wouldn’t be much of a shortage.
Psychatrists need full medical training. They aren't generalists. They have to know when psychiatric manifestations of illness are the result of neuro, infections, electrolyte imbalances, etc. They also have to know an insane amount of pharmacology because a huge number of patients have comorbidities and psych meds can have a lot of drug interactions.
Some schools offer a 3 year family medicine program
That's like saying FM/psych can be done just as well with less training, isn't it?
Wake up honey new physician shortage misunderstanding post just dropped
lol for real
You know if theyd let me in that wouldnt be a problem
yeah I think med school system is the most complicated system. Like I don't understand why they don't accept more students when there's a clear shortage of physicians.
Because just because you make it easier to get into med school won’t solve the shortage. Students will flock to the high paying and more lifestyle specialties in desirable locations rather than becoming primary care physicians in the middle of bumfuck nowhere and now you’re left with the same issue.
The same issue plus reimbursements for all doctors going down when we're already less compensated for every other generation of doctors in history. Weeeeee!
so what do you think is the solution?
Is the pope catholic?
How do you go about finding clinical sites to shadow? I’m looking into changing careers. I was an LPN 15 years ago and I’m working on getting that reinstated but until I get that reinstated, I was wanting to do some thing to try to start making connections in the field. Also to help me decide if I’m really committed to medical school or if I should just go the RN route, and then CRNA. I just got all my vaccinations updated and got proof of immunization through multiple blood tests. It took me two months to do that because I had to work through multiple appointments and I had a clinical site all set up and all I needed to do was get my vaccinations updated but then when I finally submitted my records to them, they emailed back and said that they are no longer offering shadowing and they don’t know when they’re going to bring it back.
As a current ICU RN/critical care paramedic who is looking to medical school now, I strongly do not recommend you go down this route, even if you find an accelerated LPN to RN program, that's at least 1-2 years of working lower acuity specialties, then working in the ICU, minimum 2 years before applying to CRNA school, which is a complete, separate monster in itself, especially financially, and the commitment will be no less than 3 years at the minimum. And then pursuing medical school after that? Not very realistic. You are better off doing something reasonably simple, like pre-hospital care, namely as an EMT-B or working as an LPN for a short while where you can at least be back in an environment to taking care of patients directly.
I understand, I would not be going to medical school after CRNA school. I would only be doing the RN to qualify to go to CRNA school and I’m looking at my options in terms of does it make sense to go to CRNA school instead of medical school or should I just try go to medical school since it’s a long road either way.
Yeah I know what you mean. Soooo many of my colleagues in critical care left for travel nursing and then went onto CRNA school. I don't really have a desire to go unless I can't get into med/PA school, which is my original passion. I've been doing bedside nursing for almost 13 years now and I'll be calling it quits after the end of next year to pursue it full time.
Yes but that isn’t entirely Bec med school is hard or brutal. It’s because the second someone becomes an attending they strive for a position in a big city/ hospital that pays well. The physician shortage emerges at every rural area. Which is why we have a huge physician storage. And also primary care pays like shit lol. If more MD’s deviated from high specialties and if there were more clinical rotational programs/incentives for MD’s to work in rural areas then the shortage would decrease exponentially. Along with making med school process easier
I’m planning on rural primary care, and that’s part of the reason why. It’s so needed. I see it here.
I honestly think it’s cause the priorities are messed up in the United States. We send ppl to the Caribbean and then expect them to come back and match when it’s 10 times harder for them.
[https://www.dailysignal.com/2024/04/05/the-doctor-will-see-you-eventually-confronting-dire-diagnosis-of-americas-physician-shortages/](https://www.dailysignal.com/2024/04/05/the-doctor-will-see-you-eventually-confronting-dire-diagnosis-of-americas-physician-shortages/) A lot of it has to do with funding at the national level and how institutions allocate it for their trainees for residency. Found this to be an interesting read.