More than 400 med students did not get residencies

Expert: 'We've gotten to a choke point'

Four hundred and twelve medical school students graduated this spring without residency offers, but it may reflect more on the matching system than on the students' academic performance, Brett Sholtis writes in the Pittsburgh Post-Gazette.

The toughest fields for Match Day 2014

"Medical students are used to being at the top of their game… so for some medical students, it's the first time they haven't gotten what they wanted," says Alexis Chidi, a medical student at University of Pittsburgh Medical School who knows two of the 412 students who were not matched.

Why some students don't get matched

There were more graduates than the 26,678 openings available in 2014, according to the National Resident Match Program.

"We've gotten to a choke point where there are more students graduating than are getting a residency," says Janis Orlowski, a senior director at the Association of American Medical Colleges (AAMC). AAMC predicts that the aging population, greater access to care under the Affordable Care Act, and the coming wave of physician retirements will contribute to a shortage of 130,000 physicians by 2025.

Orlowski says that the nation faced a similar shortage in the 1980s, and the federal government invested in building and expanding medical schools.

This time around, medical schools are increasing their class sizes, but there are no more residency positions open as a result. Congress has not changed its annual $10 billion allocation to fund those residencies since 1997, Sholtis writes.

Medical schools are expanding to meet demand—but will it help?

Overall, Orlowski notes, the number of graduates without residency offers actually decreased from the 528 unmatched students in 2013. Orlowski attributes this in part to graduates willingness to apply for primary care physician positions.

"Some primary care residencies did not fill in the past, and they did now, which is good," says Orlowski, adding, "Rather than everyone wanting to be a dermatologist—a very lucrative but hard-to-fill spot—people selected wisely, especially in competitive areas."

Wait until next year?

Unmatched graduates waiting to apply for residencies again next year may have to defer or start paying their student loans. According to Orlowski, the average debt of a medical school graduate is between $150,000 and $200,000.

Sticker shock: Average med student graduates with more than $162,000 in debt

Some unmatched students will do a year of research or take a fellowship, according to James Wilberger, a vice president for graduate medical education at Allegheny Health System. Others may work in pharmaceuticals or other medicine-related fields. At West Penn Allegheny Medical School, unmatched students are allowed to spend an extra year in school working in the lab.

"They can't be licensed. I just couldn't imagine [going through that]," Orlowski says (Sholtis, Pittsburgh Post-Gazette, 5/26).

Physician shortage ahead

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