4 ms·

> Enrollment != graduation and licensure. > More people may be interested but nobody can practice until after residency, and you have a large pool of hopefuls

by ardy42 6y ago

> Enrollment != graduation and licensure. > More people may be interested but nobody can practice until after residency, and you have a large pool of hopefuls basically in a lottery for residency slots. But my understanding is that residency capacity is matched to graduating class sizes, at least in the US. The selectivity is intentionally placed up front (at med school admission) so the path is clear to residency and licensure as long as the student doesn't totally fall apart (which the selectivity is supposed to guard against). IIRC, it's foreign medical school graduates may have trouble getting a US residency.

salawat 6y ago
That is not my understanding at all, as that would imply we never have med school admissions without a residency slot, and I have seen many mentions over the years about how the great bottleneck is not med school admissions, but residency slots. https://www.fiercehealthcare.com/practices/more-medical-students-than-ever-but-more-residency-slots-needed-to-solve-physician https://www.fiercehealthcare.com/practices/more-medical-stud... https://health.wusf.usf.edu/npr-health/2019-07-03/american-medical-students-less-likely-to-choose-to-become-primary-care-doctors https://health.wusf.usf.edu/npr-health/2019-07-03/american-m... The above sources indicate residency matching is decoupled from graduation from Med school, and if I recall correctly, there is actually a legal cap on the number of residency slots. https://www.aha.org/news/headline/2019-03-14-bill-add-15000-medicare-funded-residency-slots-introduced-house https://www.aha.org/news/headline/2019-03-14-bill-add-15000-... So everything I've seen suggests we actually have a dysfunctional system with no up front brakes. Our Medical education system maximizes fiscal extraction from hopefuls, but the residency slots don't scale elastically or in any way matched with demand. Quite literally, it seems to take an act of Congress to change the calculus of residency slots. I could still be wrong, and welcome the removal of the veil of mistaken impressions, but that's the gist of my current understanding.

by ardy42 6y ago

salawat 6y ago

That is not my understanding at all, as that would imply we never have med school admissions without a residency slot, and I have seen many mentions over the years about how the great bottleneck is not med school admissions, but residency slots. https://www.fiercehealthcare.com/practices/more-medical-students-than-ever-but-more-residency-slots-needed-to-solve-physician https://www.fiercehealthcare.com/practices/more-medical-stud... https://health.wusf.usf.edu/npr-health/2019-07-03/american-medical-students-less-likely-to-choose-to-become-primary-care-doctors https://health.wusf.usf.edu/npr-health/2019-07-03/american-m... The above sources indicate residency matching is decoupled from graduation from Med school, and if I recall correctly, there is actually a legal cap on the number of residency slots. https://www.aha.org/news/headline/2019-03-14-bill-add-15000-medicare-funded-residency-slots-introduced-house https://www.aha.org/news/headline/2019-03-14-bill-add-15000-... So everything I've seen suggests we actually have a dysfunctional system with no up front brakes. Our Medical education system maximizes fiscal extraction from hopefuls, but the residency slots don't scale elastically or in any way matched with demand. Quite literally, it seems to take an act of Congress to change the calculus of residency slots. I could still be wrong, and welcome the removal of the veil of mistaken impressions, but that's the gist of my current understanding.