One Quick Fix to Ease the Coming Doctor Shortage Atul Nakhasi
The White House proposes to cut on-the-job training for new M.D.s just when we need more physicians.
Ryan Scully wanted to be a doctor from the moment he began volunteering as a paramedic and firefighter during his freshman year of college. In medical school at George Washington University, he passed all of his preclinical and clinical requirements, as well as two national licensing exams required of all medical students. Just before graduation in 2012, though, he learned that he had not been accepted into a residency training program necessary for gaining his certification as a practicing physician. He would receive his M.D. degree in May with the rest of his class—but without a hospital training spot, he could not practice medicine.
Last year 1,761 M.D.s shared the same fate. And now the White House wants to set aside even less money for doctor training while reorganizing the nation’s insurance market. At a time when the new health-care law is expected to create a demand for more physicians, a proposed $11 billion budget cut over the next 10 years guarantees there will be fewer doctors. This could have a serious effect on the health of the nation.
On-the-job training of doctors is a long and complicated business, and since the introduction of Medicare in 1965 the federal government has assumed some of the cost of graduate medical education, particularly at the country’s teaching hospitals. The rationale for funding by Medicare, Medicaid, the Department of Veterans Affairs and others—nearly $12 billion a year—has been that the nation’s doctors and medical researchers will contribute to the public good, either by treating patients or contributing to advances in medicine.