San Antonio (Dec. 19, 2003) – A new survey of 73 medical school deans in the United States and Puerto Rico reveals that most deans believe the country is short of physicians in at least one specialty and that few of the deans say they have the resources to increase class size.
A second survey found that most state medical society respondents believe there are shortages in at least one specialty. A trio of researchers conducted the survey, including Steven A. Wartman, M.D., Ph.D., executive vice president for academic and health affairs and dean of the School of Medicine at The University of Texas Health Science Center at San Antonio (UTHSC). The other authors were Richard A. Cooper, M.D., and Sandra J. Stoflet, both of the Medical College of Wisconsin in Milwaukee.
The authors’ report appeared in the Dec. 10 issue of the Journal of the American Medical Association. They note that 53 of the 126 medical schools did not respond (42 percent of deans) while only 14 percent of the medical societies did not. Alaska, Florida, Hawaii, Louisiana, Montana, North Dakota and South Carolina are the states not represented.
About 85 percent of deans and medical society respondents said they perceived shortages in a specialty and most cited shortages in multiple specialties. “In seven instances, deans from three or more medical schools in a single state responded, and good agreement existed both in terms of the particular shortages of specialties cited and the severity of the shortages,” the authors wrote. The three respondents from Puerto Rico were more apt to report surpluses.
More deans reported shortages in anesthesiology (50 percent of deans) and radiology (44 percent) than in other medical specialties. Thirty percent of deans cited shortages in the adult primary care disciplines, most commonly in general internal medicine.
The 44 medical society respondents cited shortages in both specialties and primary care. Half reported existing or developing shortages in family practice and/or general internal medicine, although these shortages generally were seen as marginal or anecdotal. The deans expressed the same conclusions. Both the deans and medical society respondents shared concern about the distribution of primary care physicians.
The majority of the deans said they have no current or near-term plans to expand medical school class size. Four schools have reduced class size or have plans to do so. However, 10 deans said expansions are under way at their schools. “Applied generally, these changes in class size could yield 7.6 percent additional matriculants annually,” the authors wrote. (Matriculants in this context are medical school students.)
The authors noted that in comparison to the last major increase in U.S. medical school classes in the 1960s and ’70s, the current expansion potential is limited and fraught with obstacles. “These hurdles underscore the imperative to address physician shortages and begin to expand medical education now,” they wrote.
“A particularly disturbing result was the observation that more than 80 percent of the deans who commented on the impact of shortages on their schools noted negative effects on faculty recruitment and retention, clinical education, clinical revenues and related matters,” the authors wrote.