I’m confused. What is going on with foreign medical school graduates? I thought foreign medical school graduates – some American citizens who go abroad for medical education, others foreign citizens coming here – have been staffing a lot of residency positions in inner-city and rural hospitals. That article suggests that the practice is essentially being eliminated, and that U.S. medical schools have significantly expanded the number of graduates they produce. Is that true?
“the next link in the training chain, residency program slots, are, for all intents and purposes, capped”
If my memory serves me correct, there are more family medicine residency slots than family medicine applicants.
Is that a serious question, @PurpleTitan ?
Back in 1942 when my father was an intern at Charity Hospital in New Orleans it was pretty darned cheap. He was paid almost nothing, but provided with a room, board and free laundry. Ah, good times. I’m sure we all want to return to those days.
These days the average resident is paid $50,000 per year, with benefits and perks valued at another $50,000. Administrative expenses add another $25-50,000 per resident. Per year. (Keep in mind that residents are also either repaying loans, or deferring them while the interest acrues.) that estimate is from the following article.
http://www.modernhealthcare.com/article/20150719/news/307199999
And every resident costs staff members time. A 15 minute appointment takes twice the time (maybe not evident to the patient, but staff at the very least are consulted before, sometimes during, and after any clinical appointment. The staff member is seeing fewer (or no) patients while staffing a residency clinic. Same thing in the OR. It takes longer for residents to do procedures. There are more personnel involved. At the very least, a newish resident is being staffed by senior residents snd/or staff physicians.
@prof2dad There may be slots still available in some residency programs, particularly in primary care, because people aren’t applying for those slots. Too many applicants for lucrative (future earnings) residencies, or for future “great lifestyle” residencies. Primary care pays terribly, especially for people who have $250,000 or more in student loans, and the hours are long. People don’t want to go into family practice. So some of thise residency slots go unfilled.
@eastcoascrazy: No need to snark.
So do residents not contribute any value?
I thought this thread was about alternating between gloating over and lamenting Mizzou’s enrollment drop?
My daughter applied for Grad School in the fall of 2015, when the protests started. She was accepted with a good scholarship making the school affordable. She visited and found the program acceptable. She had other acceptances, so I steered her away from Mizzou. Simply put, there are other similar choices out there. Why even take the chance of having to deal with campus turmoil for 2 years? I believe many parents look at it the way I do.
Back to gloating/lamenting…
Last year’s drop in enrollment, had about a $30 million impact on Mizzou’s budget. This year’s drop will have a greater impact.The recently passed state budget has a 6.5 percent cut in the state’s public universities core state funding. Mizzou had to wait until the legislature was done, before it can finalize it’s FY18 budget.
http://www.columbiatribune.com/003078a4-0e98-11e7-9be8-6390879707c0.html
When our first born was being delivered at Northwestern Memorial, the OB/GYN asked if a resident could observe the procedure. I said yes, and he looked over the doctors shoulders the entire time but otherwise did not do anything.
When we got the invoice, there was a $350 charge for the residents time. I don’t know if the residents contribute to value, but they certainly contribute to the bill.
@PurpleTitan Sorry for the snark, but you could have googled the answer to your question as easily as I did.
“Do residents contrubute any value?”
Of course. But medical students rotating through teaching hospitals do not, and first year residents probably do not.
In the words of “The House of God”:
Rule 11. Show me a BMS (Best Medical Student, a student at The Best Medical School) who only triples my work and i will kiss his feet.
@profdad: Are you speaking about medical schools or colleges?
At elite colleges, it may be as low as 8-10:1, but is often 11-13, and when “low ratios” are touted for for a public universities these days is 1:18 to 1:24. Don’t even look at what ASU or UCF have.7
I understand lower ratios are necessary in med school.
@Gator88NE: Thanks. WHY is the legislature cutting funds for Mizzou as it’s struggling for students ie., revenue? Do they want it to close? What is their end goal? Because it sure looks like they want to close it or something. They already have a great public LAC and a great public Tech school, plus a bunch of not-so-good and poorly funded but serviceable directionals… do they think they don’t need a flagship? Do they only want to keep the School of Journalism, Business, etc?
If you look at the criteria, it looks like Arts&Humanities will be gutted, because by definition these bring in fewer grants and lower amounts than STEM (fewer are available and amounts are lower to start with), not to mention NEA will be eliminated or severely cut. Will there be a flagship that only offers Freshman Composition and no English degree? Only Elementary and Intermediate levels in languages but no in-depth cultural/literary study? (Both of these would be great relevance for Journalism and International Business students). Will they cut music, fine arts? What kind of a flagship are they envisioning and what reputation do they think such a flagship would have?
Those aren’t rhetorical questions BTW.
@MYOS1634 Well…I haven’t been following the Missouri legislature that closely, but keep in mind that they did increase funding last year. So this decrease is on top of that increase. They also will be letting Mizzou increase tuition, and may be funding other University items in the budget (for example, they have approved $5 million to increase the size of Mizzou’s medical school).
When it comes down to which programs to cut, the legislature doesn’t have a role. That’s up to the administration and deans. We’ll have to wait and see.
It’s like Mizzou is caught in a vicious circle, in which the response to one difficulty (low enrollment) creates a new problem (cutting programs) that aggravates the original difficult.
@MYOS1634: Have Republicans (in recent times) anywhere been in favor of funding education?
BTW, as you are likely aware, teacher-student ratios are manipulatable.
@PurpleTitan - Florida, which is run by Republicans, just passed a major increase in education funding.
http://www.miamiherald.com/news/state/florida/article129783079.html
Wisconsin, which, suffered some major education cuts after the recession, suffered cuts in order to balance the budget. Now that the education system is more efficiently run, there are some major increases in order.
The demand for US educated doctors is rapidly being filled by an alternative to old line AMA schools–DO schools. https://www.nytimes.com/2014/08/03/education/edlife/the-osteopathic-branch-of-medicine-is-booming.html
“The knock against Mizzou from Illinois kids is that it is not a Big 10 school. However, while it is a long drive, there are direct flights between Columbia and Chicago.”
Many wanted them in for the recent BIG expansions. I think they wanted in too. Not sure why they did not make the cut before all these issues surfaced.
http://www2.kusports.com/news/2011/oct/06/mizzou-official-we-wanted-big-ten-well-take-sec/
@barrons: DO schools are more financially sound because they don’t have as much research requirements, but they still have the residency limit problem.
Perhaps but they have expanded exponentially so they must have found the way to get it done.Perhaps many AMA grads dont want the career paths many DO students will accept (primary care, rural, e-room etc etc).
[url=<a href=“http://www.aacom.org/docs/default-source/data-and-trends/osteopathic-college-tuition-and-fees-(1st-year)-2016-17-and-historical.pdf%5Dhttp://www.aacom.org/docs/default-source/data-and-trends/osteopathic-college-tuition-and-fees-(1st-year)-2016-17-and-historical.pdf%5B/url”>http://www.aacom.org/docs/default-source/data-and-trends/osteopathic-college-tuition-and-fees-(1st-year)-2016-17-and-historical.pdf]http://www.aacom.org/docs/default-source/data-and-trends/osteopathic-college-tuition-and-fees-(1st-year)-2016-17-and-historical.pdf[/url] indicates that DO schools are expensive (though not quite as much as MD schools). But the potential debt load of a DO graduate may still be an issue for those going into lower paying specialties (e.g. primary care, particularly in poor areas where patients are less likely to have money or good medical insurance to pay much for care).