title: Medical education on a collision course: sooner rather than later?
abstract: The escalating cost of medical education does not have transparency. This results in high percentages of medical students with progressively rising levels of indebtedness that are only exceeded by the increases in tuition. Indebtedness is a factor in specialty choice along with the "business" of medicine that reimburses procedural-based physicians much more than cognitive primary care-based services. In response to perceived increased physician demand by 2025, medical schools have increased enrollments, and new schools are online or in development. Despite the inevitable increase in medical graduates, the number of residency positions is static and may even contract. While these phenomena are being studied individually, almost no one is examining the bigger picture: increasing numbers of highly indebted students vying for static numbers of residency positions, especially in the more highly remunerative specialties. The workforce is out of balance now, and the desired workforce outcomes are not universally agreed upon, let alone how to achieve them. This collision of forces is imminent. Family medicine can become "counter culture" once again and advocate for change with education/cost data, political expertise, and outcome measures. Returning to our roots by advocating ultimately for the patient is fundamental to our discipline.
authors: Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA. akdavid@mcw.edu
authors: Alan K
authors: AK
authors: David
mesh_terms: D004501:Education, Medical / Q000191:economics / Q000379:methods; D005194:Family Practice / Q000191:economics / Q000193:education; D018166:Health Care Reform; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D007396:Internship and Residency / Q000191:economics / Q000639:trends*; D010820:Physicians / Q000600:supply & distribution*; D011320:Primary Health Care / Q000191:economics; D013038:Specialization / Q000191:economics / Q000639:trends*; D014481:United States; D000078329:Workforce