The U.S. is facing a dire shortage of physicians, especially in primary care and some of the most critically needed specialties. The statistics are daunting, with the Association of American Medical Colleges projecting a deficit of 37,800 to 124,000 physicians over the next decade.
Many Americans are already feeling the effects of this shortage. It now takes an average of 20 days to get an appointment with a family medicine physician and 31 days to see an OB-GYN. Patients are tired of waiting. Providers are tired too, with more than half reporting burnout.
Related: Residency programs take two-track approach to training docs
These aren’t just inconveniences. Physician shortages make healthcare less accessible, less effective and often more costly. If we fail to act, these trends will only worsen. But ways exist to avert this crisis and make improvements for patients and providers alike.
One straightforward fix is to relieve the bottleneck around physician residencies.
As a physician and leader of a historic medical school, and as a member of Congress and lead sponsor of the bipartisan Resident Physician Shortage Reduction Act of 2023, we agree that expanding residency opportunities is a logical step to meet the growing need for doctors.
Residency is the next step after medical school, where new doctors participate in patient care while continuing to learn under the supervision of attending physicians. Some residents train in primary care fields—family and internal medicine; pediatrics; general obstetrics and gynecology—while others begin a longer path into specialized areas of medicine.
Regardless of training specialty, all physicians go through residency in order to become fully licensed and practice independently. A shortage of resident positions therefore represents a constraint on supply unless we flex up to accommodate the growing demand.
The power to expand residency opportunities lies with the federal government, which subsidizes this resource-intensive training through Medicare. In theory, hospitals can create residency, or graduate medical education, positions without funding from the Centers for Medicare and Medicaid Services, but many hospitals operate on razor-thin (or even negative) margins—particularly rural and safety-net hospitals, where additional residencies are needed most. In practice, the number of eligible residency slots for most hospitals has been frozen at 1996 levels.
This creates a real chokepoint in the physician pipeline—limiting the number of available doctors as the U.S. population continues to grow.
Incremental improvements have been made in recent years: For example, CMS will phase in 200 new residency slots annually over the next five years, mostly in primary care and high-need mental health fields. While those numbers represent movement in the right direction, this alone is far from being enough.
The Resident Physician Shortage Reduction Act, which is pending in both the House and Senate, would go even further in creating additional residency slots—14,000 over seven years—to help get doctors into practice where they’re needed most, including in rural and underserved communities.
Medical schools are prepared to help meet future demand. Without sacrificing the quality and credentials of those accepted, enrollment in medical schools is already increasing, up nearly 18% from 2012 to 2022. However, simply increasing medical school enrollment won’t put more doctors into practice unless we also create opportunities in the next phase of medical training.
Even today, thousands of soon-to-graduate medical students fail to match into residency programs. In 2023, 42,952 applicants vied for 40,375 positions. A similar imbalance was reflected in 2022, when 42,549 students applied for 39,205 placements. Many of these graduates are highly qualified and will nevertheless go on to practice as great physicians; but they will be delayed by a year and required to compete for limited slots with the following year’s graduates. We need them on the frontlines now.
Of course, expanding residency slots will not solve the physician shortage entirely. But it will make a meaningful and measurable impact, especially in high-demand fields like primary care and psychiatry, as well as for underserved communities in rural and urban areas. It is rare for a complex policy problem to have such a straightforward and actionable solution.
The bipartisan Resident Physician Shortage Reduction Act is widely supported by diverse stakeholders, including the American Hospital Association, the American Medical Association, the Association of American Medical Colleges and the American Association of Colleges of Osteopathic Medicine. With both the House and Senate considering a much-needed expansion in residency positions, let’s hope floor action in both chambers is on the horizon.
