Too Many Medical Students:Too Few Residency Spots?

The Osteopathic ViewpointMark Cummings, Ph.D.Associate Dean, SCScummin67@msu.eduMAME May 25, 2011

Part I: COM Historical Developments

• Pace of COM Growth

•Enrollment Trends

•New Models for COMs

•Disconnect with Osteopathic GME

•What the Future Bodes for COMs

Total Enrollment in COMs1968-2010

Data drawn from the AACOM Annual Osteopathic Medical School Questionnaire

1968 1973 1978 1983 1988 1993 1998 2003 2004 2005 2006 2007 2008 2009 201002468

10121416182022

Thousands

Total Enrollment

Total Enrollment 1.879 2.780 4.221 6.212 6.614 7.822 9.882 11.857 12.525 13.406 14.409 15.634 16.893 18.143 19.427

Part II: Postdoctoral Efforts To Keep Up

• Understanding Osteopathic GME

• Trends and Capacity in OGME

• Limited Educational Offerings

• A Troubled Future for Graduates

Trends in Osteopathic Matching1988-2011

*Data drawn from AOA Office of Education and the AACOM Annual Report

1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 20110

500

1000

1500

2000

2500

3000

Funded Slots Number Matched

No. of Non-Participants Unfilled Slots

Funded Slots 1515 1701 1799 1676 1877 1878 1814 1989 2147 2206 2312 2443 2553

Number Matched 1369 1257 1145 1385 1255 1353 1314 1291 1205 1196 1353 1473 1640

No. of Non-Participants 661 663 994 1212 1363 1356 1748 1992 2114

Unfilled Slots 146 502 654 291 622 525 500 698 942 1010 959 970 913

AOA Deficit in Residency Positions2005 to 2011

.

2005 2006 2007 2008 2009 2010 2011 20120.4

1.6

2.8

4

Thousands

Match Participants

Option 1 & 2 Slots

Residency Deficit

Match Participants 2.908 2.886 3.173 3.600 3.899 4.106 4.581

Option 1 & 2 Slots 928 1.030 1.154 1.558 1.754 1.801 1.918

Residency Deficit 1.980 1.856 2.019 2.042 2.145 2.305 2.663

Top Ten Postdoctoral Choices2011 AOA Match Results

Specialty Number PercentFamily Practice 373 22.7

Internal Medicine 305 18.6Trad. Internship 245 14.9Emergency Med. 214 13.1General Surgery 102 6.2

Orthopedic Surgery 84 5.1OB/GYN 69 4.2Pediatrics 53 3.2

Anesthesiology 27 1.6Diag. Radiology 24 1.5

Positions Left Over in the AOA Match Program

2006-2011

Year Traditional Internships

Family Practice

Internal Medicine

Other Specialties

# of Unmatched

Students

Unfilled Positions

2006 615 170 93 132 123 1010

2007 534 180 88 120 182 922

2008 397 310 152 100 273 959

2009 422 306 173 101 361 1002

2010 379 339 174 78 423 970

2011 390 333 144 46 572 913

Number of DOs Scrambling*2006-2011

*Includes Current and Past Graduates

Year Match Participants

AOA Match Results

NRMP Match Results

No. in Scramble

2006 2886 1196 1024 6662007 3173 1267 1136 7702008 3600 1353 1339 9082009 3899 1433 1408 10582010 4106 1473 1444 11892011 4581 1640 1561 1380

DOs in Residency Training, 1995-2009Totals in AOA and ACGME Programs*

*DOs in AOA/ACGME Accredited Programs are Counted Twice

Year AOA ACGME Total Percent in AOA

1995 2606 3333 5939 43.9

1996 2141 3288 5429 39.4

1997 2632 3367 5999 43.8

1998 2998 3639 6637 45.1

1999 2928 3869 6797 43.1

2000 2781 4175 6956 39.9

2001 2499 4658 7157 34.9

2002 2532 5327 7859 32.2

2003 2523 5838 8361 30.2

2004 2422 5675 8097 29.9

2005 2535 6474 9009 28.1

2006 2989 6629 9618 31.1

2007 3289 6784 10073 32.7

2008 4794 7237 12031 39.8

2009 5247 7628 12875 40.8

Number of DOs in ACGME Residencies, 1992-2009 The Annual Number of DO Graduates, 1992-2009

92 94 96 98 OO O2 O4 O6 O8 O91200

2000

2800

3600

4400

5200

6000

6800

7600

DOs in ACGME Progs. No. of DO Grads.

DOs in ACGME Progs. 3137 3264 3288 3639 4176 5327 5675 6629 7237 7628

No. of DO Grads. 1532 1732 1932 2096 2279 2536 2769 2814 3462 3724

Any Cogent Insights to be Gained From this Presentation??

Based on Current Trends, Here are Some Concluding Thoughts

• The Number of COMs Will Continue To Increase Into the Future

• The Osteopathic Student Population Will Continue to Expand

• OGME Will Grow Slowly and Not Match the Pace of the COMs

• Osteopathic Dependence on ACGME Programs Will Increase

• Heightened Competition for AOA & ACGME Slots Will Occur

• The Number of AOA/ACGME Programs May Decline

• Osteopathic Medicine Will Remain Rooted in Primary Care

• The Disparity Between Students and GME Slots Will Worsen