Comment by jyounker
3 months ago
The USA restricts the number of positions for medical schools and residencies. It's a problem that money could solve.
3 months ago
The USA restricts the number of positions for medical schools and residencies. It's a problem that money could solve.
There is no restriction on medical school admissions. It's really just residencies.
There are no artificial restrictions on residency slots. The Federal government funds a fixed number of slots, but states and hospitals also fund residencies. The "shortage" has much to do with geography and specialty--the money and interest is working in specialties on the coasts, not as a GP in rural towns. People who are rejected are typically vying for slots in high-demand areas and specialties; they often could have been accepted if they had applied elsewhere.
One answer would be to raise GP salaries, but that's difficult, especially if you're self-funding residencies and already paying out the nose for specialists and other inflated expenses deemed necessary in modern healthcare systems. Kaiser California imports medical school graduates from abroad for their in-house residency programs, which is presumably cheaper than raising salaries to draw more US resident candidates.
Kaiser arguably points the way forward. As an HMO--a vertically integrated healthcare system--there's greater financial incentive to self-fund residencies. When insurers, hospitals, and doctors are all at arms length from each other, the financial incentives don't align very well, thus the "need" for outside funding (i.e. the government) of residencies.
Note that unfunded residencies are also a thing, where the resident is responsible for sourcing the funds for their salary and expenses.
My understanding is that this is a distinction that doesn't make a difference? Without a residency, can you become a doctor?
Yes, because you have to be (or be about to be and in time to start) a doctor in order to be apply for residency.
Resident doctors are doctors, exactly as junior SWEs are software engineers.
(UK doctors have for some reason long objected to 'junior' and recently become 'resident doctors' over exactly this. All the more confusing - throughout and still there's been 'Senior House Officers', because 'house' used to be what it was called, like US residency, doing house, there were junior and senior house officers, so why not just revert to that? Who knows, but now they're all resident doctors - and some of which are senior house officers - until they're registrars/consultants, and they're happier with that than junior doctors.)
That's mostly correct, but there are a few students who enroll in medical school with no intention of becoming practicing physicians. They want to go into some other career like research or technology or hospital administration.