title: Exploring the workforce implications of a decade of medical school expansion: variations in medical school growth and changes in student characteristics and career plans.
abstract: OBJECTIVE
  To explore whether medical school enrollment growth may help address workforce priorities, including diversity, primary care, care for underserved populations, and academic faculty.
  
  
  METHODS
  The authors compared U.S. MD-granting medical schools, applicants, and matriculants immediately before expansion (1999-2001) and 10 years later (2009-2011). Using data from the American Medical Association Physician Masterfile and the Association of American Medical Colleges, they examined medical schools' past production of physicians and changes in matriculant characteristics and practice intentions.
  
  
  RESULTS
  Among the 124 schools existing in 1999-2001, growth varied substantially. Additionally, 11 new schools enrolled students by 2009-2011. Aggregate enrollment increased by 16.6%. Increases in applicants led to a lower likelihood of matriculation for all but those with rural backgrounds, racial/ethnic minorities, applicants >24 years old, and those with Medical College Admission Test scores > 33. The existing schools that expanded most had a history of producing the highest percentages of physicians practicing in primary care and in underserved and rural areas; those that expanded least had produced the greatest percentage of faculty. Compared with existing schools, new schools enrolled higher percentages of racial/ethnic minorities and of students with limited parental education or lower income. Matriculants' interest in primary care careers showed no decline; interest in practicing with underserved populations increased, while interest in rural practice declined.
  
  
  CONCLUSIONS
  Despite expansion, the characteristics of matriculating medical students changed little, except at new schools. Further expansion may benefit from targeted consideration of workforce needs.
authors.affiliation: Dr. Shipman is director of primary care affairs and workforce analysis, Association of American Medical Colleges, and research assistant professor of pediatrics and of community and family medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. Ms. Jones is senior data analyst, Center for Workforce Studies, Association of American Medical Colleges, Washington, DC. Ms. Erikson is senior director, Center for Workforce Studies, Association of American Medical Colleges, Washington, DC. Dr. Sandberg is research writer, Center for Workforce Studies, Association of American Medical Colleges, Washington, DC.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Shipman
authors.forename: Karen C
authors.initials: KC
authors.lastname: Jones
authors.forename: Clese E
authors.initials: CE
authors.lastname: Erikson
authors.forename: Shana F
authors.initials: SF
authors.lastname: Sandberg
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002321:Career Choice; D016009:Chi-Square Distribution; D018864:Cultural Diversity; D005180:Faculty, Medical / Q000600:supply & distribution; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D058007:Physicians, Primary Care / Q000193:education / Q000600:supply & distribution; D011320:Primary Health Care; D019035:Rural Health Services; D012577:Schools, Medical / Q000458:organization & administration* / Q000706:statistics & numerical data / Q000639:trends; D013337:Students, Medical / Q000706:statistics & numerical data*; D014481:United States; D000078329:Workforce