Something doesn’t seem right. On one hand, we have alarming statistics about the physician shortage across the United States, and on the other hand, it’s incredibly difficult to become a doctor. In fact, some of the more competitive medical schools in the U.S. accept less than 4 percent of applicants. We need more doctors, but it’s so difficult to become one. What gives, and what are the implications for our future doctors?
How Hard Is It To Get Into Medical School?
Statistics from the Association of American Medical Colleges, or AAMC, reveal a steady increase in the number of applicants to medical school each year. In the 2018-2019 cycle alone, only 21,600 out of close to 53,000 applicants successfully matriculated. That’s a success rate of only 40%, meaning most med school applicants fail to get accepted to any medical school. And the competition is getting stiff – the average MCAT score of matriculants in this year compared to the previous year has increased by close to a full point.
The reason it’s becoming so competitive is simply a matter of supply and demand. Younger generations are particularly eager to pursue a career in medicine, as it allows for a positive impact on society, emphasis on science, technology, and interpersonal connections. It allows for autonomy and critical thinking. It pays well too. Being a physician is a pretty great job.
Why is there a Physician Shortage Then?
The 2018 AAMC Physician Supply and Demand Report projects a total physician shortage between 43,000 and 121,000 physicians by 2030. That’s just 11 years away. And because it takes so long to train physicians, we need to get started on addressing these issues sooner rather than later.
Population growth and aging are the primary drivers of increasing demand between 2016 and 2030. During this period, the U.S. population is projected to grow by 11% from 324 million to 359 million. More specifically, the population under the age of 18 is projected to grow only 3%, while the population over 65 will grow by 50%. And we all know that seniors have a much higher per capita consumption of health care than younger generations.
Given the medical school admissions statistics, the solution seems obvious – open more positions in medical schools! But the situation is more complex than that. Since 2002, class sizes have risen by approximately 30%. More students are matriculating to medical school than ever before. So what gives?
The doctor shortage has multiple causes beyond just medical school class sizes. One factor, for example, is the number of U.S. doctors who are nearing retirement age. Another factor is that today’s doctors are more eager to find work-life balance than their predecessors. Doctors from previous generations often chalk this up to millennials being entitled and lazy, but I’d argue against that. In fact, if you want to see me compare medicine in the old days versus modern day, including which parts are harder and easier in each, let me know with a comment down below. It’s a topic I’m considering if there’s enough interest for it.
Certain regions have more severe doctor shortages because physicians prefer to live in wealthy metropolitan areas with an abundance of highly educated individuals like themselves. But it’s the low income areas, with less educated populations, that are in the greatest need of physicians. Additionally, most medical schools are in these metropolitan areas that already have plenty of physicians. And freshly trained doctors usually practice close to where they went to school or close to their hometowns.
But these factors all pale in comparison to one. Arguably the most important and severe limitation is the number of residency positions. It doesn’t matter how many fresh medical school grads you’re minting if they aren’t able to complete their residency training. This scarcity of U.S. residencies has created a bottleneck in our doctor supply chain.
Why Don’t We Have Enough Residency Positions!?
Residency positions in the United States are funded by Medicare. Therefore, to increase the number of practicing doctors, you need to increase Medicare funding. Unfortunately, calls to increase Medicare spending to fund new residency slots is usually met with deaf ears on both sides of the aisle.
For that reason, funding hasn’t increased since 1997. It’s ultimately in the hands of federal legislators.
However, the Resident Physician Shortage Reduction Act of 2019 proposes adding up to 15,000 new Medicare-funded residency positions over a five year time span. It was introduced to the Senate earlier this year, and in my opinion, would be a big step in the right direction.
Will Medical School Always Be This Competitive?
Everyone knows it’s incredibly competitive to get into medical school, particularly one that is highly esteemed. But I don’t think it will always be to this extreme. It will always be relatively competitive compared to other professions, as it’s a great field. Not only are you intellectually stimulated and helping patients, but you also have rock solid job security, a very high salary, prestige, and professional flexibility.
That being said, it’s far from perfect, and the public perception of medicine will eventually catch up to the reality. Currently, society at large has rose tinted glasses about what it means to be a physician – remnants of the golden age of medicine. The reality is less ideal. Physician burnout and suicide rates are at an all time high, as are student loans, and physicians’ interests are being encroached upon from multiple angles as we are notoriously bad at advocating for ourselves.
I’m not trying to dissuade people from becoming doctors, but I do think that out of all the students interested in becoming physicians, some portion of them would be happier doing something else. If you’re unsure whether or not it’s a good field for you, I’ve written a post specifically to answer that question.
As a pre-med, its stressful and frustrating that getting into medical school is so competitive. I get it. I was once in your shoes too. But as a patient or even a physician, you want the medical school application process to be competitive. You want the best and brightest to become doctors.
Look at the significant hurdle of getting into medical school as the first step in demonstrating your commitment to the field. Medical schools don’t design the application process to be easy. Medical school is tough, and they need to ensure those who are accepted can handle the rigorous coursework and endure the challenging clinical training. It’s in their best interest to identify the top candidates who will ultimately thrive in medical school and become stellar physicians.
Several years ago, having a high GPA and MCAT was enough to open doors. Since then, things have changed. While these objective measurements are good predictors of your USMLE Step 1 score, they’re not good predictors of whether or not you’ll be a good physician. Being a physician is a multifaceted profession, and personal strengths in addition to academic strengths are essential. Are you a leader? Have you demonstrated compassion? Are you resilient? A team player? Medical schools look to these questions to evaluate you as a candidate.
Most pre-meds focus on a checklist mentality – I need to do some volunteering, some clinical exposure, a little bit of research, check, check, check. Medical school admissions committees can see right through this on your application and during the interview. Even with a top GPA and MCAT score, your chances are slim if you fail to demonstrate your personality. Instead of a checklist mentality, I’m a strong advocate of a narrative based application.
Have you noticed that the average GPA and MCAT at some top medical schools aren’t as high as you’d expect? Why isn’t every matriculant getting at least a 90th percentile MCAT score? There are plenty of applicants with strong numbers that lose spots to those with weaker numbers. It’s because of the power of a strong narrative. What is your story to landing on the medical profession? Why should our medical school pick you as an applicant? Do you add value and diversity to the class – a unique background, interests, or skills? Are you resilient and able to handle the arduous training in medical school and beyond? These are some of the questions you should be asking yourself while completing your application.
And whatever you do, don’t make your personal statement just a rehashed version of your CV. This is by far the most common mistake we see applicants make and it significantly reduces the strength of your application. “I wanted to become a doctor because of A, then I did clinical experience B and learned important lesson C. Then my research in X taught me Y and now I’m going to focus on becoming Z, etc.” This is the checklist mentality in practice and most students don’t even realize their essay comes off this way until we’ve shown them.
This is one of the many things we focus on at Med School Insiders. We understand the importance of a narrative based application over a checklist mentality because our team of physician advisors has served on medical school and residency admissions committees. They know firsthand how to make an applicant stand out and how to get them accepted. Learn more about our pioneering approach and why we have the highest satisfaction rates in the industry. The first 30 customers to sign up for our services will receive $30 off their purchase using the coupon code COMPETITIVE2019.