An advisory group to Congress adopted several key recommendations on expanding the number of U.S. physicians, including striving for a 15% increase in the number of medical school graduates by 2015 and the creation of additional residency positions. The Council on Graduate Medical Education (COGME), authorized by Congress in 1986 to assess trends in the physician workforce, endorsed a plan to raise the number of medical school graduates by 3,000 over the next dozen years and similarly increase the number of doctors entering residency programs to 27,000 in 2015 from about 24,000 in 2002. The group acted on a report by Edward Salsberg, executive director of the Center for Workforce Studies at the State University of New York, Albany. Increasing medical school graduates by that amount probably would require four or five new medical schools in the U.S. in addition to the 126 allopathic medical schools now in the nation, Salsberg said. COGME, based in Rockville, Md., also accepted a recommendation to end a goal of having a 50-50 mix of primary care and specialist physicians in residency programs, which is likely to expand the number of specialist slots available.
The council's action, taken at a meeting last month, could signal a dramatic shift in the way the federal government views the physician population in this country, Salsberg said. "I think it reflects a changing of the official position of the council, and I think it reflects a change in thinking in this country," he said. "There's been a worry for the last 20 years about doctor surpluses. Now, what is likely to become a major issue over the next 20 years is a doctor shortage." Salsberg projected a U.S. shortage of 85,000 to 96,000 physicians by 2020. For its part, COGME may cease to exist unless its charter is reauthorized in the federal budget for fiscal 2004. -- by Michael Romano