Reports of physician shortages have surfaced for decades, but recent projections by the Association of Medical Colleges show even greater shortages by 2025, warning that the physician workforce will not be able to meet a growing patient demand.
“Medicare funds graduate medical education right now and we just don’t have the amount of funding coming from the national government anymore, “ said Kiki Nissen, associate dean for graduate medical education and faculty affairs at UConn Health. “Hospitals in general are not looking for ways to increase their residency numbers. That’s where the bottleneck is going to be.”
Despite the inability of residency positions to meet the growing cohort of medical school graduate students, Fejiro Okifo, an eighth-semester physiology and neurobiology major, said she is has no fear when it comes to the future she imagines for herself as a physician.
"I’m not afraid that I’m not going to get into a residency program,” Okifo said. “A part of it is knowing your strengths and which programs are good for you.”
Okifo has been applying to medical schools since last May and said that she will make her decision by the end of this month. She applied to a wide range of schools, including UConn Health and Boston University School of Medicine.
“I came to UConn as a pre-med student, and I wanted to be a doctor because both of my parents are nurses, which introduced me to the medical field at a very young age,” she said. “Also, another big reason is that in Nigeria, I had relatives that were experiencing sub-par care.”
Because of projections showing a shortage of physicians, medical schools have responded by increasing their numbers, Nissen said, but it still takes a lot of time before the increase makes a difference in recruiting more physicians. Medical students still have to go through four years of medical school and numerous years of residency before becoming practicing physicians. This takes eight to 12 years.
“I don’t think this will have a huge impact for UConn because we generally put out great students,” Nissen said. “Although students’ perspectives are always that of worry.”
Nissen listed some reasons why there have been physician shortages.
“We have positions that are aging out,” she said, meaning the physician workface is getting older. “People are also living longer with many more complex medical problems.”
Even though the health care system is doing a better job with preventative medicine and chronic care, she said there are still more patients than ever before because people are living longer. The Affordable Care Act has also put millions of people into the system who have health insurance.
“We don’t have the physician workforce to take care of that,” she said.
Younger physicians are taking the roles of physicians who retire, but not at a fast enough pace to keep up with the patient demand.
“Medical schools are certainly starting to increase in number,” she said. “There has been growth in allopathic medical schools, but osteopathic medical schools have even more dramatically increased in numbers.”
Allopathic medical schools train medical doctors (M.D), while osteopathic medical schools train doctors of osteopathic medicine (D.O). The differences between the two deal with the way each practices medicine, but many argue that the difference is slim.
Students’ worries, she said, center on questions about whether they will get the right residency or match in the right specialty.
“I’ve been practicing for a while and my dad was a primary care physician,” Nissen said. “The way I grew up with my dad, it was all about the patient.
There wasn’t much concern over getting sued or making sure documentation was right, she said. Today, physicians are required to interact not with the patient, she said, but with a computer on which electronic records are now kept.
“One of the things I would say to my patients is,” she said. “’Listen. I’m listening to you, but I’m also typing. I’m not ignoring you, but I’m not necessarily looking at you either.’”
Everything needs to be signed, she said. For example, paperwork with insurance companies and pharmacies is becoming “mind-blowing.”
Now, there are medical scribes that act as physician-helpers and deal with the paperwork, but many hospitals can’t afford a scribe for every physician, Nissen said. Another problem is that doctors still have to review what the scribe writes to make sure it’s accurate, which also takes time and results in what she calls “double-work.”
Nissen, who is a graduate of UConn Health, said being a physician is one of the most rewarding experiences, and added UConn students are at an advantage when it comes to their education and readiness for medical schools and residencies.
Despite this, she said 4,000 applicants, primarily from outside of the country, applied for 45 residency positions in internal medicine alone this year.
“I think the reason for the physician shortage is that it’s competitive to get a job,” Okifo said. “America also makes the medical school application process a lot more complicated than it needs to be.”
Diler Haji is a staff writer for The Daily Campus and can be reached via email at firstname.lastname@example.org.