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RESIDENCY: Article in Top Medical Journal Concludes Residency Squeeze Is Unlikely

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Sommerhalder and Veatch, RUSM alumni
Joseph A. Flaherty, MD, dean and chancellor of Ross University School of Medicine, shares his views on a recent New England Journal of Medicine article that questions the idea of a residency cliff.

This blog entry was written by Joseph A. Flaherty, MD, dean and chancellor of Ross University School of Medicine (RUSM). It is in response to a November article from the New England Journal of Medicine, titled "Why a GME Squeeze Is Unlikely."

Fitzhugh Mullan, MD, writes in the November 4, 2015 edition of the New England Journal of Medicine that, assuming the continuation of current trends in both US medical school growth and residency growth, a decade from now the number of first-year residency positions (34,000) will still outnumber the number of job-seeking US medical school graduates (29,500) by about 4,500. With graduate supply growing at a rate of 2.4% annually, and residency positions (or graduate medical education) growing at a slightly slower rate of 1.66%, the gap is definitely narrowing.

But it’s not a residency squeeze, as many observers believe. And there certainly is no need to fear a residency cliff.  

RUSM Graduates Positioned to Claim Open Residency Spots

I expect that as this slow tightening occurs, graduates of RUSM will continue to claim a significant number of positions in the Match – competing not only for the surplus of positions unfilled by US medical school graduates, but for every available position. One reason is our track record: residency program directors know RUSM and have seen how well our graduates perform. In the most recent match, over 800 RUSM graduates earned US residency positions, a record number for our institution*, and achieved an 88% first-attempt residency match rate*. We also saw more than 35 RUSM graduates be named chief resident of their program this fall.

But there are other factors that help prepare our graduates to succeed in The MATCHSM. One is that we prepare them well—not just academically, but for the process of applying to and interviewing with residency programs. This has been a significant focus for our team and we believe it is having a positive impact on our graduates’ competitiveness in the match.

The Real Reason Residency Programs Exist

In “Why a GME Squeeze Is Unlikely,” Dr. Mullan makes a very important point not only about the supply of graduate medical education positions, but about the overall purpose of GME. Residency programs don’t exist to provide each medical school graduate with a pathway into the career of their choice. Rather, they exist to serve the healthcare needs of the country.

Thus, according to Dr. Mullan—and I concur with him—the gap between the number of graduates and number of positions is actually a healthy one. It compels our graduates, and those advising them, to have realistic expectations about what specialty they want to pursue, and encourages a healthy distribution of positions into areas of need, such as family medicine.

RUSM and many regional/community-based schools are responding to this challenge by supplying a significant number of primary care doctors who also later practice in underserved community areas. I am proud that at RUSM we are striking a healthy balance on this front: preparing our brightest and highest-performing graduates to choose any path they wish, while at the same time supplying the US healthcare system with an annual influx of primary care physicians to serve a critical need.

*Institutionally reported data. See hyperlinks for more information.

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