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New
Entrants and Choice of Medical Specialty
Almost 24,000 physicians complete their
training through programs of graduate medical education
(GME) each year. Before completing residencies and fellowships,
new physicians must earn a four-year college degree and
complete four years of medical education. Four out of five
physicians completing GME are graduates of United States
medical schools. Most are graduates of schools of allopathic
medicine, which annually graduate approximately 15,000 to
16,000 MDs. This number has been relatively stable since
1980, and the baseline projections assume that the U.S.
will continue to graduate approximately 16,000 MDs per year
through 2020. Schools of osteopathic medicine graduate approximately
3,000 DOs per year, and the baseline supply projections
assume that this number will steadily increase to approximately
4,000 per year over the next decade.
Over
5,000 IMGs are accepted into United States GME programs
each year. An increasing percentage of IMGs are citizens
or permanent residents (US IMG) who graduated from medical
schools in other countries. Foreign IMGs under enter the
United States for GME under the temporary work (H) or training
(J) visa programs. Foreign IMGs with a J visa can participate
in the J-1 Visa Waiver Program, which allows physicians
to remain in the United States, if they agree to provide
primary care services in federally-designated health professional
shortage areas (HPSAs) for a minimum of three years after
completing their residency. The PSM projects the number
of IMGs who will remain in the United States based on historical
patterns that vary by specialty.
The
PSM models specialty choice based on the number of medical
graduates entering different GME residency programs, historical
trends of specialization as estimated through an analysis
of the AMA Masterfile data, and data from the AAMC medical
school Graduation Questionnaire. A more complete description
of the specialty allocation is provided in other reports
(e.g., Altarum, 2000). Specialty choice varies substantially
by gender and by whether students are USMGs or IMGs. Among
USMGs, for example, female physicians are three times more
likely to become pediatricians than are male physicians. |
