Some med school grads have nowhere to go

Hundreds of thousands of dollars in debt, and no residency. That’s the situation for 412 medical school graduates this year in the United States.

A residency — paid, onthe-job training — is an essential step in becoming a medical doctor. In some cases, students’ failure to obtain a residency has nothing to do with their performance, but rather with the supply and demand of the system that allocates them, the National Resident Match Program.

It also has to do with simple math. The National Resident Match Program’s annual report, released in May, shows 26,678 positions. For the second year in a row, the number of graduates exceeded the number of residencies available.

Medicare funds those residencies, costing $10 billion a year. Congress set this allocation in 1997, and it has remained unchanged since then.

But not for lack of trying. In 2013, lawmakers introduced two bills, the Resident Physician Shortage Reduction Act and the Training Tomorrow’s Doctors Today Act. Neither bill passed the House of Representatives.

Janis Orlowski, the senior director in health care affairs for the Association of Ameri- can Medical Colleges, said Congress needs to increase funding to prevent a catastrophic shortage of doctors.

“We’ve gotten to a choke point where there are more students graduating than are getting a residency,” Orlowski said.

This residency shortage comes at a time when demand for doctors is increasing, she said. An aging population, an increase in the pool of insured people due to the Affordable Care Act, and the fact that almost a third of all physicians are expected to retire in the next decade all contribute to the rising need for new doctors. Her organization, interpreting U.S. Census data, predicts a shortage of 130,000 physicians by 2025.

Orlowski said that when she was in medical school during the 1980s, the country faced a similar physician shortage, which led to a federal investment in building and expanding medical schools.

This time around, medical schools have increased class sizes in response to the shortage, which is a good start, she said. But without an increase in the number of residency positions, the number of doctors cannot increase — no matter how many people graduate from medical school.