<p>Hi,</p>
<p>Someone at my school when I told them this said that I should be able to make medical school, even with terrible scores (ie 3.7 29-31 MCAT) because they are anticipating a huge shortage of doctors, which will make med school admission a lot easier. Is there any truth to this statement, or what do you think?</p>
<p>A 3.7 31 is above the national average for students who are eventually admitted to medical school.</p>
<p>And yes, medical schools have tentative plans to slightly increase medical school spots.</p>
<p>Yes there will be some increase in the overall number of spots available, but I don't necessarily think that there will be that large of drop in the average stats of matriculants. There will have to be a rather large drop in the number of applicants for a significant increase in the number of "less qualified" matriculants. I don't think that going from a 45-50% acceptance rate to a 55% acceptance rate is going to make that big of difference. </p>
<p>If anything a decrease in applicants is probably tied to a decrease in less qualified applicants as they are more likely to be the applicants who look at the poor economy and decide to remain in school. If there is a strong economy, they are more likely to be heading out in to the job market.</p>
<p>yes a speaker told me that medical schools are opening up more to allow more doctors to be circulated.</p>
<p>Bigredmed, what is the average GPA of medical school matriculants?</p>
<p>3.6. Average MCAT is 30.</p>
<p>there's a guaranteed med prgm that I'm looking at: you have to hold a 3.7 science GPA, but you don't have to take the MCAT. Do you think it's worth it?</p>
<p>The AMERICAN MEDICAL ASSOCIATION finally did confess and basically state (in so many words) that "yes, all those people back in the 1970s and 1980's claiming that not enough american trained medical doctors were being produced - were probably right"</p>
<p>However the AMA will continue to drag their feet - increasing enrollment by only relatively small amounts - and perhaps lettting a few more foreign trained doctors enter as needed</p>
<p>Why not - they already have a near total legal monopoly at this point</p>
<p>The AMA does not decide medical school enrollment rates. Even the AAMC holds little sway over member schools.</p>
<p>However you have to realize that just b/c being in scarce supply is an economic benefit to doctors, there are other factors like access to care that ethically play a role in decisions by Medical College deans and staff when determining enrollment...It's hard to explain but as one progresses through medical school things like "Do no Harm" and access of care become huge considerations.</p>
<p>BBK: Depends on what they ask you to give up and what they are promising you. Could you be attending a great undergraduate school but are instead ending up one you like much less just for the guarantee? Is the med school a place you like, or just one that's safe? I do think that the "requirements" are often... how to say this? Overvalued by students evaluation BS/MD programs. Truth is that if you rig things right you can hit whatever targets you want, and no target is ever going to be harder than what the school would want anyway.</p>
<p>CX: I often get the AMA and the AAMC confused. But for the record, almost nobody in the 70s and 80s was claiming that not enough doctors were being produced. In fact, the very opposite phenomenon is often now cited as an example of how it's very difficult to predict trends in health economics.</p>
<p>BRM: Really - I had thought the AAMC exerted quite considerable influence. (I have often stated that I thought it was the AMA.)</p>
<p>"Do no harm", of course, involves rejecting flat-out underqualified candidates, putting a downward pressure on medical school enrollment size. (At least, this is as far as I could apply it.) Wanting to increase access, of course, puts an upward pressure on enrollment.</p>
<p>I shouldn't post after I've been drinking...I'm not sure where the do no harm thing came from. I guess I was trying to impart that going through medical school changes one's perceptions of problems...</p>
<p>I've always thought, and I could be wrong, that the AAMC can encourage and persuade and make calls for changes to academic medicine, but was not a legislative body passing down edicts to member institutions. It's like the difference between the National Panhellenic Conference and the North American Interfraternity Conference. NPC is comprised of the 26 national sororities and routinely passes bylaws affecting the operation of every member chapter in the country and how they operate. The NIC (representing 66+ Fraternities), like the AAMC, is more of a lobbying group that can pass recommendations on to its members, but those can be ignored. In the NIC's case, their edicts are more often than not disregarded, but of course, the AAMC probably has greater effectiveness than the NIC and so their statements probably have a greater effect. Again, that's how I see it, and I could be extremely wrong.</p>
<p>The AMA is THE MAJOR FACTOR in determining the current supply of doctors in the United States </p>
<p>The AMA has control over residency programs and is THE major factor in deciding the numbers of schools approved and the amount of american trained doctors produced. The AMA is the single most influential group affecting these matters</p>
<p>American Medical Associations Council on Medical Education is involved in:</p>
<p>"The study and evaluation of all aspects of medical education, including ensuring that there is an adequate continuing supply of well-qualified physicians to meet the medical needs of the public;</p>
<p>The review and recommendation of policies for medical education;</p>
<p>The consideration and recommendation of the means and methods whereby physicians may be assisted in maintaining their professional competence and the development of means and criteria for recognition of such achievement; and</p>
<p>The responsibility that the AMA remains an accredited sponsor of continuing medical education." </p>
<p>as for the shortage issue - an excerpt from an article last year in USA Today</p>
<p>"The predictions of a doctor shortage represent an abrupt about-face for the medical profession. For the past quarter-century, the American Medical Association and other industry groups have predicted a glut of doctors and worked to limit the number of new physicians. In 1994, the Journal of the American Medical Association predicted a surplus of 165,000 doctors by 2000. </p>
<p>"It didn't happen," says Harvard University medical professor David Blumenthal, author of a New England Journal of Medicinearticle on the doctor supply. "Physicians aren't driving taxis. In fact, we're all gainfully employed, earning good incomes, and new physicians are getting two, three or four job offers."</p>
<p>The nation now has about 800,000 active physicians, up from 500,000 20 years ago. They've been kept busy by a growing population and new procedures ranging from heart stents to liposuction.</p>
<p>But unless more medical students begin training soon, the supply of physicians will begin to shrink in about 10 years when doctors from the baby boom generation retire in large numbers.</p>
<p>"Almost everyone agrees we need more physicians," says Carl Getto, chairman of the Council on Graduate Medical Education, a panel Congress created to recommend how many doctors the nation needs. "The debate is over how many." </p>
<p>Getto's advocacy of more doctors is remarkable because his advisory committee and its predecessor have been instrumental since the 1980s in efforts to restrict the supply of new physicians. In a new study sent to Congress, the council reverses that policy and recommends training 3,000 more doctors a year in U.S. medical schools.</p>
<p>Even the American Medical Association (AMA), the influential lobbying group for physicians, has abandoned its long-standing position that an "oversupply exists or is immediately expected." </p>
<p>Getto sounds to me like he's with the NCGME. Not the same as the AMA.</p>
<p>And yes, this confirms what I was taught in class and what I said above re: glut vs. shortage of doctors.</p>
<p>The AMA does not control medical schools, medical school class size or the ACGME. </p>
<p>The AMA does not represent all physicians nor does it exert much power over anything. See the AMA's own "Council on unity" documents bemoaning the AMA's lack of effectiveness.
<a href="http://www.ama-assn.org/meetings/public/annual00/reports/cou/coua00.doc%5B/url%5D">http://www.ama-assn.org/meetings/public/annual00/reports/cou/coua00.doc</a>
<a href="http://www.ama-assn.org/meetings/public/interim00/reports/rcf/cou-i00.rtf%5B/url%5D">http://www.ama-assn.org/meetings/public/interim00/reports/rcf/cou-i00.rtf</a></p>
<p>The AAMC does not control medical schools.
See the AAMC site: <a href="http://www.aamc.org/about/voice/start.htm%5B/url%5D">http://www.aamc.org/about/voice/start.htm</a></p>
<p>See the ACGME site for AMA and AAMC roles.
<a href="http://www.acgme.org/acWebsite/about/ab_ACGMEbylaws09_06.pdf%5B/url%5D">http://www.acgme.org/acWebsite/about/ab_ACGMEbylaws09_06.pdf</a></p>
<p>You will note that none of the announcements of increasing medical school class size made any reference to obtaining permission from the AMA for such action.</p>
<p>The AMAs influence in the United States concerning medical issues exceeds by a wide margin any other similar group</p>
<p>The AMERICAN MEDICAL ASSOCIATION which is w/o any doubts one of the most powerful lobbying groups in the entire world has de facto primary control over the quality and supply of doctors trained in medical schools in the United States, and the AMA has been of critical importance (particularly over the last 40 years) in shaping the legislation and regulations that form the basis of America's healthcare system, and especially affecting the (now very limited) supply of american trained doctors. No one is claiming ALL medical doctors belong to the AMA nor is it being stated that the AMA by law has absolute control over this issue - it is simply the most powerful group in existence in regards to these matters. </p>
<p>The fact is todays shortage of american trained medical doctors is is entirely consistent with the long term efforts of the AMA to create a medical cartel in the United States</p>
<p>AMA's critical role in reference to the U.S. MEDICAL SCHOOL ACCREDITATION PROCESS via the LCME is as follows:</p>
<p>"The U.S. Department of Education recognizes the Liaison Committee on Medical Education (LCME) for accreditation of programs of medical education leading to the M.D. in the United States. For Canadian medical education programs, the LCME engages in accreditation in collaboration with the Committee on Accreditation of Canadian Medical Schools (CACMS). The LCME is recognized as the reliable accreditation authority for M.D. programs by the nation's medical schools and their parent universities. It also is recognized for this purpose by the Congress in various health-related laws, and by state, provincial (Canada), and territorial medical licensing boards.</p>
<p>The LCME. The 17 members of the LCME are medical educators and administrators, practicing physicians, public members, and medical students. The Association of American Medical Colleges (AAMC) and the Council on Medical Education of the American Medical Association (AMA) each appoint six professional members. The AAMC and AMA each appoint one student member. The LCME itself appoints two public members, and a member is appointed to represent the CACMS. </p>
<p>The LCME is represented by ad hoc teams of evaluators who conduct on-site surveys of medical schools. Survey team members are a mix of basic science and clinical educators and practitioners. Members of the LCME and surveyors conducting field evaluations serve as voluntary, peer evaluators. The activities of the LCME are administered by two Secretariats, at AMA headquarters in Chicago, IL, and at the offices of the AAMC in Washington, DC. Members of the LCME and its survey teams, excluding full and part-time staff, serve the LCME without compensation." </p>
<p><a href="http://www.lcme.org/overview.htm%5B/url%5D">http://www.lcme.org/overview.htm</a></p>
<p>While the AMA may be physicians' best advocate, the AMAPAC has been relatively ineffective in influencing legislation addressing Medicare reimbursement rates, tort reform, the expansion of non-physician scope of practice and the corporate (HMO) practice of medicine.</p>
<p>The LCME, as noted, is responsible for accrediting medical school programs. In this respect, the AMA, acting through the LCME can affect the quality of medical graduates, but not the supply.</p>
<p>While the AMA may in fact wish to create a medical cartel in the United States, the simple reality is that such a thing does not exist: physicians kow tow to hospital administrators, accept abuse from insurance companies on a daily basis and practice medicine to address legal requirements instead of clinical needs. If this is a cartel, it was poorly thought out.</p>
<p>See the 2006 AAMC "Medical School Expansion Plans" document. Section 4 details barriers to enrollment expansion including concerns about the quality of applicants. Section 5 discusses the applicant pool.
[quote]
Growing evidence indicates that the nation will face a shortage of physicians in the next one to two decades. The Association of American Medical Colleges (AAMC) recommended a 15% increase in the number of U.S. medical school graduates in 2005 and is currently considering a new recommendation of a 30% increase in enrollment by 2015 compared to enrollment in 2002.1 A 15% increase in allopathic enrollment would be equal to about an additional 2,400 students per year; a 30% increase would require nearly 4,800 per year. While osteopathic enrollment and graduations have grown over the past 25 years, their continuing growth by itself will not be sufficient to meet the needs of the nation. </p>
<p>A 15% or 30% increase in enrollment would yield fewer allopathic medical school spots per capita than
1980 levels, these changes will require a major shift in direction for these schools; medical school enrollment in allopathic institutions grew by less than 2% between 1980 and 2003. Given the long timeframes needed to expand medical school capacity (and to educate and train physicians), immediate
efforts are required to meet AAMC goals.</p>
<p>To better understand and inform the expansion plans of medical schools, the AAMC Center for Workforce Studies undertook the second annual survey of all U.S. allopathic schools in the fall of 2005. Most of the information contained in this report was provided by 116 allopathic medical schools that
participated in the survey. The Center also gathered public information on new medical schools planned in the U.S. to provide a more complete picture of the current status of enrollment expansion.
[/quote]
</p>
<p><a href="http://www.aamc.org/workforce/enroll.pdf%5B/url%5D">http://www.aamc.org/workforce/enroll.pdf</a></p>
<p>an excerpt from recent story in the Boston Globe - reflective of just one aspect of an entirely larger issue, however strangely enough this at one of the top hospitals in the world, in one of the top medical education cities in the world - in regards to primary care doctors</p>
<p>Dr. Sherry Haydock consulted with patient June Robinson of Milton at Massachusetts General Hospital in Boston. (Suzanne Kreiter/ Globe Staff) </p>
<p>By Liz Kowalczyk, Globe Staff | November 12, 2006</p>
<p>Most primary care physicians at Boston's top-tier teaching hospitals are so busy that they have officially closed their practices to new patients.</p>
<p>Callers to Massachusetts General Hospital's physician referral line, for example, are told that all, or almost all, of the hospital's 178 primary care physicians are not accepting more patients. All 42 internists at Boston Medical Center have had full lists since four months ago, and 108 of Brigham and Women's Hospital's 120 primary care doctors have closed their practices to new patients.</p>
<p>Determined patients, however, are getting in to see some of the city's best doctors through informal channels, from e-mailing doctors personally to asking family members and acquaintances to use their connections.</p>
<p>"There is a huge crisis in primary care right now," said Dr. Sherry Haydock, medical director of Internal Medicine Associates, a primary care practice at Mass. General. "If you have a family member already cared for at the hospital, you have a much higher likelihood that a doctor will take you. But as our [practices] have gotten to 150 percent the size they should be, a lot of us realize we have to say no even to family members."</p>
<p>Many doctors blame a national shortage of primary care doctors for the limited access, but the reasons are more complex and vary among hospitals. Many internists, especially women, are cutting back their hours to spend more time with their families. At the same time, the aging population and the increasing complexity of medicine mean that each patient requires more time and services -- reducing the number of patients some doctors can see.</p>
<p>see complete article at <a href="http://www.boston.com/business/healthcare/articles/2006/11/12/hospital_doctors_shut_doors_to_new_patients/%5B/url%5D">http://www.boston.com/business/healthcare/articles/2006/11/12/hospital_doctors_shut_doors_to_new_patients/</a></p>
<p>"Many doctors blame a national shortage of primary care doctors for the limited access...."</p>
<p>True, but the reason for this shortage is economic, not regulatory. Primary care docs work long hours, are less well compensated and, unfairly, receive less recognition than specialists. </p>
<p>The AMA, primarily an organization of internists, has for years called for more generalists and fewer specialists. The recent Medicare fee update increases reimbursement to primary care docs at the expense of certain specialists.
See the CMS press release on Physician Payment Rates And Policies For 2007 at <a href="http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2044%5B/url%5D">http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2044</a>. Note the language indicating increased reimbursement for E & M services and the lack of language indicating dramatically decreased reimbursement for certain specialties.</p>