How the Residency Match Cap Affects the Doctor Shortage — and How Locum Staffing Can Help

How the Residency Match Cap Affects the Doctor Shortage — and How Locum Staffing Can Help

March is a fateful month for America's aspiring physicians. Each year, the third Friday of March is Match Day, the day in which medical students discover whether they've been matched to a residency training program and can therefore begin their graduate medical education (GME) training — the final stage, short of credentialing, in the process of becoming a practicing physician.

And as momentous as this event is for medical students, it's equally so for the nation's healthcare employers. As the United States continue to struggle with a shortage of doctors (which we've documented at length here at the Staff Care Insider), the process of Match Day is coming under increased scrutiny from many quarters.

So, what's the connection? What effect does the yearly residency match have on the nation's doctor shortage? The relationship is significant: As the only process by which new physicians are brought into practice in the United States, healthcare employers are dependent on the residency match process to infuse the healthcare system with new doctors.

And the need for new doctors is growing more serious each year, as more physicians aged 55 and older make immediate plans to retire, largely out of dissatisfaction with the current healthcare workplace. (Read more about the increasing retirement rates among older physicians here.)

But there are limits on the number of new doctors allowed under the current residency match system. Although the number of medical students graduating rises each year — thanks to more students, as well as the opening of new medical schools and expansion of class size within existing schools — no corresponding increase in the number of residency training slots has also occurred.

Doctor Shortage Draws Attention, Scrutiny to Residency Match Cap

Although the ongoing physician shortage "speaks to the need to expand the number of residency training slots," as the American Association of Neurological Surgeons' Neurosurgery Blog points out, that number remains static thanks to a 1997 congressional cap on GME funding.

Limiting the number of new doctors across all specialties — despite radical changes in the healthcare marketplace that have taken place in the 20 years since it was passed (as part of the Balanced Budget Act of 1997) — the cap "is highly problematic because it is not the number of medical students trained but rather the number of positions in the GME system that determines the supply of physicians," the Neurosurgery blog adds.

“This nation needs far more family medicine physicians than the current numbers are achieving,” agreed American Academy of Family Physicians (AAFP) President Dr. Wanda Filer in an interview with Internal Medicine News. Dr. Filer went on to lament that the growth in residency slots “is not fast enough, and our antiquated graduate medical education payment is misaligned with U.S. workforce needs.”

Indeed, the cap seems to be at odds with the expanding need for physicians in the United States, and an increasing number of professional organizations are calling for an overhaul.

“The Balanced Budget Act (BBA) of 1997's resident limits impose significant limitations on the ability of teaching hospitals and medical schools that sponsor and conduct graduate medical education programs to respond to the needs of the communities they serve, the current policy is beginning to impede the continued development of the educational mission at many teaching institutions,” states the American Association of Medical Colleges (AAMC) on its website.

The cap is also at odds with the fact that, each year, the residency match registers record-breaking numbers of physician applicants. "The number of applicants registered for the 2016 Match reached an all-time high of 42,370, an increase of 1,036 over 2015," as noted by the National Resident Matching Program (a.k.a. NRMP, a.k.a. "The Match"), the non-profit organization that organizes and runs residency matching in the United States.

"For students who have spent four years in college and four years in medical school (racking up an average debt of over $160,000 in the process), the prospect of not matching is a grim one," writes Staff Care's own Vice President of Communications, Phil Miller. "For those who believe the nation is in the midst of a growing physician shortage, the fact that U.S. medical school graduates may not be able to find residencies is discouraging, to say the least."

Match Day 2017, then, is certainly a time to welcome and celebrate a promising new crop of medical residents, but also "a time to consider the cap on residency funding that is inhibiting physician supply," Miller writes.

"How many medical school graduates will have to be turned away before the cap is lifted?"

Meeting Doctor Shortage Challenges with Locum Staffing

What does all this mean for the nation's healthcare employers struggling with the ongoing doctor shortage? Depending on what type of facility you represent, you may either be intimately involved in the residency matching process as part of your hiring process, or barely aware of it.

And this feeds some of the controversy surrounding the physician shortage process: namely, the fact that a somewhat small number of residents choose to stay and practice medicine full-time at the facility where they've undertaken their residencies (particularly in rural areas) and instead seek opportunities elsewhere. As a healthcare employer, it may be either be in your best interest to hire these newly-minted physicians fresh off of their residences, or you may be looking for ways to retain the residents you currently have on staff.

In either situation, locum tenens staffing can offer a solution.

Residents are increasingly being encouraged to learn about the locum tenens process at earlier stages in their training, and are more aware than ever of the career opportunities that it represents. These benefits — such as the chance to gain experience across a variety of facilities relatively early in their careers, before committing full-time to a permanent role — also represent a significant advantage to healthcare employers that eventually hire these new physicians.

Another result of the industry's increasing use of locum tenens workers is that these physicians now represent a high-tier cross-section of medical professionals, from new physicians fresh out of their residencies to seasoned doctors with decades of experience. This is another clear benefit to the nation's healthcare employers, as well as to the physicians themselves.

If you represent a healthcare facility struggling with a shortage of doctors, or simply interested in leveraging locum tenens physicians to round out your strategic staffing plan, we encourage you to contact a Staff Care representative today. You can also fill out a locum tenens request form here.

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