Blog Archive

Tuesday, October 17, 2017

Uncle Sam Wants You! / Residency Shortage





Uncle Sam Wants You! / Residency Shortage


The only way the residency shortage will resolve in a timely fashion depends on YOU!  I mean this literally.  There is a no “One” person who can effect this change before countless fully qualified doctors are “lost”.  It will take a groundswell of voices to bring this travesty to the forefront of our Nation.  We need YOUR VOICE.

 

The solution to the residency shortage will not be linear.  As you have read, some states are creating legislation to “preserve” their unmatched doctors until the number of residency slots catch up.  Some states are increasing their budgets to teaching hospitals to underwrite the addition of residency slots and the beginning of new residency programs.  Some states are allowing other health care professionals to perform services once performed only by doctors.  Some states are still “wallowing” in bureaucratic doldrums.  The solutions are a “little bit of this and a little bit of that”.

 In the meantime, thousands of unmatched doctors are dealing individually with an unimaginable “betrayal” and all that it encompasses (school loans, no career path, and despondency).  They “did” what we told them to do, and we “broke the contract”.  Ultimately, “we” will pay the price for this travesty.  Right when the baby boomers tap into healthcare the most, there will be a doctor shortage.  Forget about “preventative care”.  We will be lucky to get “reactive care” for our healthcare challenges.

 When the Balanced Budget Act of 1997 reduced the reimbursement for residencies, yet increased the number of medical schools, the resulting impact has been devastating.  “We” knew this Act was not perfect at the outset, and changes would have to be made.  Little did we know the “individual” repercussions that would ensue. 

 These unmatched doctors have worked so hard, for so many years, and at such great expense, not to be able to complete the final step in their training.  The “right hand” of Congress definitely did not know what the “left hand” was doing.  We have got to make this RIGHT! 

 
 Only your voices and those of your contacts can effect the “tsunami” needed to bring this solution to the forefront.  Please write, tweet, share, and “demand” a solution now!

http://nomatchmds.blogspot.com/

Tuesday, October 10, 2017

Second-Half Summary/ Residency Shortage








Second- half Summary/Residency Shortage


Here is the second half of the “story”:

 
  • What is the AMA doing?
  • The Nation has broken the “Social Contract”
  • 25% international medical graduates do not match, yet ECFMG has been monitoring and making recommendations to them for 60 years!
  • We want to think US Medical Schools are “better”, yet individual learning and passing of the “Criterion Task” have leveled the field.  Only fully qualified applicants are eligible to participate in the NRMP in the first place!
  • ACGME is not in favor of Missouri’s plan for Assistant Physician License, yet has not taken the lead in finding a solution
  • AMA and ACGME, two of the most influential agencies in Medical Education, are not leading in timely fashion to prevent an utter waste of human talent
  • The impending doctor shortage will be more than 90,000 doctors short in the next decade
  • Some question the legitimacy of the “Doc Shortage”.  Either the demographics are correct, or they are not!  Baby Boomers are ageing and will require even more medical care.  Is this really politics trying to use lesser trained medical professionals to provide patient care at lower costs, using physician assistants and nurse practitioners?
  • Are P.A.s and N.P.s as qualified as MDs?
  • A number of states are approaching this problem but tend to favor their own residents
  • Need a “tsunami” of outrage to solve this
  • Need action by each person concerned about this solution

Tuesday, October 3, 2017

Solve DOC Schortage State by State







Solve DOC Shortage State by State

https://www.youtube.com/watch?v=YSaPTPzTRyY

 

Until the residency deficit has been resolved, I suggest that each state “preserve” its own doctors.  Currently, the “best numerical candidates” prevail in the residency match (see previous blogs).  That would have to change. 

The tradition of Medical Education is to “reward” the “best” students.  The students with the best GPA, the best test scores, get into the most competitive schools and residencies.  It’s hard to change that mindset.  Every institution wants to attract “the best”.  Any graduate doctor who has passed the requirements of “The Match” already is “the best”.

 I recall the tuition for medical school in South Carolina 5-10 years ago.  Tuition for in-state residents was approximately $50,000/year, and out-of-state $80,000/year.  I remember thinking that if accepted to a South Carolina medical school, a student could get their education, but South Carolina would not be underwriting any part of that cost.  South Carolina would not share in the expense of a doctor’s education, only to have the graduate leave upon graduation.

 Here are the dollars that Florida has allocated to increase the numbers of residencies in the state:

  • 2013, $80 Million for recurring State and Federal funding for Graduate Medical Education (residencies)
  • 2015, additional $100 Million appropriated by Florida Legislators for “Graduate Medical Education Startup Bonus Program”
  • Program “Gives hospitals a one-time $100,000 Bonus for every new residency slot in shortage specialties” (1)
  • The first year 66 new residency positions in seven shortage specialties qualified for the bonus” (1)
  • Florida faces a shortage of 7,000 physician specialists by 2025
As described in a prior blog, Arkansas and Kansas are garnering doctors for their own states.  Their residency solutions apply only to their citizens.  Until the residency deficit is eliminated, I believe that Florida should do the same.  Florida tax dollars are providing the monetary incentives to increase the number of residencies in Florida.  So Florida residents and its unmatched doctors should benefit.  Residency selection in Florida residencies should be skewed toward residents of Florida, not using the traditional numerical ”cutpoints”.  Florida is addressing the residency shortage by allocating tax dollars to increase the number of residencies.  The State of Florida and its doctor grads should benefit from these tax dollars.  These are the doctors who plan to live, work, and stay in Florida.

(1)http://wusfnews.wusf.usf.edu/post/florida-increases-medical-residency-slots-still-faces-doctor-shortages#stream/0

http://nomatchmds.blogspot.com/
 

Tuesday, September 26, 2017

Slam Dunk? / Politics / Residency








Slam Dunk?/ Politics/Residency
https://www.youtube.com/watch?v=DZt3xeV_n00&t=2s

   Too many medical students, yet not enough residency slots.  Impending doctor shortage, yet “discarding” fully educated doctor grads.  Why isn’t the solution to this dilemma a “slam dunk”?  Because nothing is ever that simple.  There are the “politics” involved that complicate the solution to this deficit. 

                                                            (Bloom's Taxonomy) 

    Is there really going to be a physician shortage, or are the VA, The Affordable Care Act, and some states planning to utilize less expensive physician assistants and nurse practitioners to administer healthcare?   Josanne Page of the Cleveland Clinic said, “P.A.s generally make about half a physician salary or less, depending on specialty (an ER doctor makes an average $270,000, an emergency-room P.A. $112,000).” (1)

 “ And several states, such as Arizona, Maine, Maryland, Nevada, Vermont, and Washington have liberalized laws to enable nurse practitioners and PAs to perform some treatment normally done by doctors.” (2)  The Affordable Care Act has allowed millions more insured patients, with a shortfall of sufficient doctors to treat them.  Compared to other countries, the US has 2.5 practicing physicians per 1,000 people vs. 3.2 physicians per 1,000 for an average of 34 other countries. (3)

 Is a PA or NP qualified to see patients as effectively as a doctor?  A PA curriculum typically requires 1 year of classroom learning and 1 year clinical work.  A NP requires a 1-3 year program post graduate after obtaining a nursing degree.  Doctor training requires a minimum of 7 years after college.  The 3 doctors in my family had 7 years, 10 years, and 11 years of post college training.  The further depths of knowledge and medical experience afford a doctor a level of synthesis not attainable with lesser years of study. 

 A dermatologist I know recommended that a patient obtain a consult regarding a skin ailment, sometimes associated with pancreatic cancer( The patient returned to thank the doctor for the early diagnosis of pancreatic cancer which might have been missed under normal circumstances.)  Would a PA have known that correlation? 

  An OB/GYN doctor told a patient to obtain further diagnostics for continued lactation after cessation of breast feeding.  There is an association with pituitary tumors with uncharacteristic lactation.  The patient did end up having a pituitary tumor.  Would this have been noticed by a PA?  Often, a doctor never enters the room when a PA is seeing a patient.

     Ironically, PAs who by “definition” are “supervised” by a doctor, are allowed to work immediately after graduation.  A doctor with 4 years of medical school cannot work at all, until obtaining a license upon completion of a residency.  They can’t even work as a PA due to the stringent PA licensure rules!
 
(1) http://www.nytimes.com/2014/08/03/education/edlife/the-physician-assistant-will-see-you.html?_r=0

(2) http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/08/11/to-address-doctor-shortages-some-states-focus-on-residencies

 
(3)http://www.epi.umn.edu/mch/wp-content/uploads/2013/09/ACA-Overview.pdf

http://nomatchmds.blogspot.com/
 

Tuesday, September 19, 2017

Doctor Shortage / Waste





Doctor Shortage/Waste
https://www.youtube.com/watch?v=DZt3xeV_n00&t=2s

Image result for people queue images free 

 

   Let’s talk about the upcoming doctor shortage.  Here are some statistics and projections:

  • 27.6% of the current physician workforce are age 60+ years old and likely to retire in the next 10 years (1)
  • 32.6% of practicing physicians are women
  • 46.1% of residents are women
  • “Historically women have worked fewer hours than men-a trend that continues today” (2)
  • 24% of current US physician workforce are IMG (International Medical Graduates)
  • 25.9% of US “ resident” workforce are IMG
  • “By year 2025 the United States will face a shortage of between 61,700-94,700 physicians”. (3)
  • “Thousands of baby boomers are turning 65….seniors are the population with the greatest healthcare needs”. (4)
  • “The Association of American Medical Colleges (AAMC) projects there will be a shortage of between 12,500-31,100 primary care physicians in the next 10 years…equally troubling is the shortage of between 28,200-63.700 specialists.”(4)
  • More than 40,000 fully qualified doctors have not matched into a residency over the last 5 years and cannot practice Medicine without residency training.
  • 8,640 doctors did not match on March 17, 2016, what are they doing now?
  • “With medical school and residency combined, it takes a minimum of seven years to train a doctor.” (4)
What are we thinking?!!!  In view of the upcoming doctor shortages over the next decade, we are simply “discarding” our fully educated doctors!  This just does not make sense!

 

(1)   page 12

(2)   page 13

(3)

(4 )page 1

(3)   page 2

Tuesday, September 12, 2017

ACGME (Accreditation Council for Graduate Medical Education)/ IMG





ACGME (Accreditation Council for Graduate Medical Education)/ IMG
https://www.youtube.com/watch?v=hL3mwmLdMZE

Image result for maze images free     The ACGME, via CEO Thomas Nasca MD, does not support the legislation enacted in Missouri.  It deals with using unmatched doctors in underserved rural areas, supervised by a licensed physician within a 50 mile radius.  The doctors could work and reapply for a residency, while performing meaningful and necessary work until the number of residencies catches up with the deficit.  Dr. Nasca bases this belief on patient safety and quality concerns.(1)  He further states that once an unmatched doctor has gone through 2 application cycles, he/she will probably never get trained.  They will remain untrained for the duration of their career.  Dr. Nasca also infers that unmatched international medical graduates are not as smart as US grads, or they would have been accepted into a US medical school.  It sounds like Dr. Nasca is not too worried about unmatched IMGs (International Medical Graduates)!

 I can certainly see the points Dr. Nasca makes about patient safety and quality.  Yet, residency also deals with training “new doctors” under a supervisory set of physicians, albeit closer in proximity.

 However, I have a different opinion about the qualifications of the IMGs.  Two of my own children have graduated from medical schools, one a US grad and one an IMG.  As an educator and mother, I would categorize the child who went to a US medical school as “system smart”, and the one who went to an IMG as “intellectually smart”.

  The US grad decided to go to medical school 2 years after graduating from college in “Broadcast Journalism”, with an “A” average.  The IMG attended the same, very competitive university (97% of incoming freshman have an academic scholarship), intending to go to medical school from the beginning, and majored in “Cell Science/Microbiology”, obtaining a “B” average.  The US grad attended a local less competitive university for pre-med classes and got an “A” average.  The IMG grad took pre-med classes, along with a competitive pre-med science major, while at the highly competitive university, getting a “B” average.

 The US grad was accepted “Early Decision” into a medical school with 1 application.  The IMG med student was only accepted into an international med school.  Two graduates, fairly comparable intellectually, one worked “smarter” in applying for medical school, while the other majored in a subject intended to “help” in Medicine.  It pays to know the system before you begin!

 Yes, this story deals with only 2 medical students. There is a whole “continuum” of ability and IQ in MDs, some are “book smart” and some are “system smart”.  Probably all applicants wished to have gone to a US medical school.  They would not have had to deal with this residency deficit, waited heavily against IMGs.  In spite of all these points, all doctors applying through NRMP have PASSED ALL THE REQUIREMENTS!  Why shouldn’t they be allowed to complete the last step of their training!

 As CEO and spokesperson for the ACGME, I believe Dr. Nasca has a responsibility to suggest a workable solution to this residency dilemma.  Not only is a solution warranted, but leadership in this role of CEO for such a vital organization in medical education is warranted!  If such leadership had taken charge of this travesty, we would not be talking about each state enacting its own legislation.  We would not be dealing with the utter waste of human time, talent, and money.  The AMA has “adopted” a similar stance, based on Dr. Nasca’s recommendation.  So 2 of the most powerful agencies dealing with healthcare in the US are leaving it up to others to fix this bureaucratic nightmare!

Tuesday, September 5, 2017

A Tale of 3 Medical Students




A Tale of 3 Medical Students 
https://www.youtube.com/watch?v=6s1_3ZTanUg

Here’s how medical school works…The first 2 years of medical school cover the acquisition of medical knowledge.  This occurs through lectures, reading, study, and testing.  The acquisition of this knowledge occurs through individual interaction and involvement with the subject matter.  The last 2 years of medical school include monthly clinical rotations at hospitals and clinics in the subspecialty areas of Medicine.  The student treats patients under the supervision of residents, faculty, and attending physicians.  Supervised clinical practice uses the knowledge acquired from the first 2 years of school on real patients for the last 2 years.  Here are examples of how 3 real medical students approached their learning.

 “John” attended the University of Illinois Medical School in the early 1970s, earning the honorary designation of “James Scholar”.  This honor entitled him to the exclusive use of a study carrel at the medical school, and the privilege of designing his own course of study, as long as he passed all requirements and exams.  John’s method of study involved reading each medical text book cover to cover, not attending class, and graduating in 3 years.

 “Mary” attended a US medical school in the South.  Her method of study for the first 2 years was as follows.  She listened to her online class lectures at an accelerated rate of speed on her computer.  She varied her locations between her apartment, Starbucks, and Panera Bread Company.  Her clinical rotations were taken at a variety of hospitals and clinics in the greater metro area around her medical school.

 “Joe” attended An international medical school.  He attended class lectures, read, studied, and took exams.  His clinical rotations took place in the New York City metropolitan area for the last 2 years of medical school.

 These 3 students each had a different approach to the didactic portion of their medical knowledge.  The clinical rotations were a fairly uniform experience, all taken in the US.  They all graduated from accredited medical schools with an MD degree.  They all passed USMLE parts I and II.  They all applied for residency through NRMP.  Haven’t they all fulfilled their side of the “Social Contract”?  Don’t they all deserve the opportunity to complete the final step in their training? 

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Tuesday, August 29, 2017

Our "Social Contract" / NRMP





Our “Social Contract”/ NRMP
https://www.youtube.com/watch?v=0TigWx26pCc
Image result for contract images free 

All US citizens who have satisfied the requirements for an MD degree, and passed all required exams (USMLE I AND II), have earned the right to train and practice Medicine in the US.  This is our “Social Contract”.  Think of medical school as one big “lesson plan”.  As teachers know, each lesson plan begins with the “Behavioral Objective” and ends with the “Criterion Task”.  If the goals and benchmarks outlined in the Criterion Task have been met, the Behavioral Objective has been met.  US medical schools and government legislatures have determined the criteria required to practice Medicine in the US.  All medical school graduates who apply for residency through the NRMP (National Resident Matching Program) have met these criteria, both US medical school grads, as well as international medical school grads.  They have all passed the CRITERION TASK!

 Why aren’t we “upset” if 25% of unmatched grads are from international medical schools, especially since 42% of them in 2016 were US citizens?  Currently, 25% of physicians practicing in the US are international medical school graduates.(1) Considering the expected 90,000+ doctor shortage over the next decade, that is quite a waste of fully educated doctors!

 The ECFMG (Educational Council for Foreign Medical Graduates) has been promoting excellence in international medical education for 60 years! (1) This organization has been evaluating the readiness of IMGs (International Medical Graduates) to enter GME (Graduate Medical Education) programs in the US.  It has partnered with NBME (National Board of Medical Examiners) to develop the clinical skills assessment for the USMLE (US Medical Licensing Examination).  To become an accredited medical school with the SAME STANDARDS as a US medical school, a foreign med school has passed rigorous standards and criteria.

 “The ECFMG makes its world-class experience with the primary-source verification of medical education credentials available to the international medical regulatory community.”(1)  It is recognized world wide.  This is the organization monitoring graduates of international medical schools  The IMGs applying through the NRMP have met the “Criterion Task” for entry into US residencies!

Tuesday, August 22, 2017

What is the American Medical Association Doing? AMA




What is the American Medical Association doing?


            According to CME Report 3-A-16, from the Council on Medical Education, the AMA recognizes the funding and distribution of residency positions for GME (Graduate Medical Education) are “in crisis in the US and that meaningful and comprehensive reforms are urgently needed”.  This report focused only on US medical school seniors, and does not include International Medical Graduates (IMG).  Currently, 25% of practicing physicians in the US are graduates of international medical schools.(1)  Many of these are US citizens who attended international medical schools.(2)  Here are some of the points made in this report and Resolution 308 (A-16):

  • “There is a predicted physician shortage of between 46,100 and 90,400 physicians by 2025” (AAMC, March 2015)
  • The overall match rate for US and IMG medical students was 75.2%
  • The majority of the 25% not matching are International Medical Graduates(IMG)
  • There has been continuous growth of US medical schools and increased enrollment
  • There has been limited growth in Graduate Medical Education (residency positions) due to caps in federal funding (The Affordable Care Act)
  • The AMA “will strenuously advocate for legislation” along with the AAMC (Association of American Medical Colleges) to increase federal funding of GME
  • Medical school seniors’ “fear of being a loser” have caused residency applicants to apply to an average of 47 programs to avoid not matching into a residency (up 20% in the last 5 years)
  • This has forced program directors to use USMLE scores and quantitative criteria as a numeric “cutpoint” rather than perform an in-depth review of every application
  • USMLE  scores alone are NOT predictors of success in residencies
  • The AMA is opposed to state legislation for licensing “untrained” doctors on the basis of patient safety and quality concerns
If the AMA says the number of GME positions is in “crisis”, yet does not support state legislation for licensing unmatched doctors, how can this catastrophic deficit in residency slots be rectified before these fully educated and qualified doctors are forced to leave Medicine?  More than 40,000 doctors have not matched already in the last 5 years.

 Why isn’t the plight of unmatched international medical graduates as crucial as that of graduates of US medical schools, since 42% of IMG in 2016 were also US citizens?

 Are US medical schools better than IMGs?  Are US graduates smarter than IMG graduates?

 (1)   http://ecfmg.org/about/history.htmlhttp://ecfmg.org/about/history.html
 (2)   Report of the Council on Medical Education, CME Report 3-A-16

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Tuesday, August 15, 2017

Snail Mail Worked! / Doctor Shortage





Snail Mail Worked! / Doctor Shortage


There was a great revelation that occurred during the frustrating process of trying to contact my legislators.  After no responses to my countless emails and phone calls, I realized that doctors who are members of the State medical association have MEDICAL PRACTICES!  I googled the names and addresses of members of both the State and National Legislative Councils for the Florida Medical Association.  My husband and I sent letters by US mail to each of these council members.  Within days my husband received phone calls from a number of these doctors.  They were very interested in the issue of “Residency Shortage”, and quite appalled by the current travesty.

 It turns out, most physicians and healthcare professionals, do not really know the enormity of this situation.  The ramifications for unmatched graduate doctors unable to complete their training are appalling.  The natural consequence of “discarding” thousands of graduated and fully qualified doctors at a time when there is an impending doctor shortage (up to 90,000 doctors over the next decade) is complete insanity!

 This is all going on ”under the radar”. These unmatched doctors are so mortified and despondent, they’re not broadcasting this dire situation to friends and family.  It is very humbling, because 20 years ago and before the Balanced Budget Act of 1997, all doctor graduates matched into a residency.  The impression is that somehow they have failed, when it is the system which has failed them.  They are not stupid, there is a SHORTAGE!

 Why hasn’t the AMA solved this crisis?
http://nomatchmds.blogspot.com/
 

Tuesday, August 8, 2017


HCA Is at the Forefront of a Solution to the
Residency Shortage



Hospital Corporation of America is leading the charge for a timely solution to the Residency Shortage nationwide.  “Nationally, HCA is one of the largest GME providers, with more than 203 programs….Currently 2,750 residents and fellows are participating and that number is expected to grow to 5,500 by 2020”.(1)  This would mean an additional 70 residency programs.  Perhaps other hospital corporations will follow HCA’s example.  The slow moving bureaucracies of Medicare Funding, the ACGME (Accreditation Council of Graduate Medical Education), and state licensure laws have precluded a timely solution in the public sector. 

Here is what is going on in Florida, where HCA says, “The physician shortage is especially critical in Florida”.  An IHS Global study found that Florida faces a shortage of about 7,000 physician specialists by 2025.  The Teaching Hospital Council and Safety Net Hospital Alliance report said, “We are not, to put it bluntly, training enough physicians….Without more physicians, Florida will have a tough time providing quality health care to our growing, aging and increasingly diverse population.”  You may recall from a prior blog that in 2015 Florida began a “GME Start-up Bonus Program” which funded $100,000 for each new residency “slot” in shortage specialties.  I would assume that HCA is taking advantage of these bonuses to help fund their new residency slots.  In Florida, HCA says,”Currently 336 residents …are training at one of our seven teaching hospitals, with plans to expand to more than 550 residents by the 2018-2019 academic year.”

The other 49 states seem to be approaching these Residency and Doctor Shortages in many different ways.  I see the private sector approach working very nicely in Florida, and would encourage other states to offer similar incentives to the hospital corporations operating in their states.  However, I would still mention that until the Residency Shortage is solved, each state give preference to its own citizen applicants for residency, as well as those unfortunate doctors who have not matched in prior years.  Upon completion of residency, many doctors opt to practice in the state of their training.  Why should a state offer incentives for new residency slots, only to have these trained doctors leave their state when finished? 

(1) HCA West Florida 2017 Community Report

www.NoMatchMDs.blogspot.com
 

Tuesday, August 1, 2017






Help Create the Tsunami of Outrage / Residency Shortage
 
https://www.youtube.com/watch?v=BOK9A7WdZvA

My last blog delineated the problems in bringing the Residency Shortage to the Nation’s attention.  No “one” person can solve this crisis, it involves too many variables:  ACGME accrediting, Medicare funding, and states legislation to “preserve” unmatched doctors.  My solution was to create a “Tsunami of Outrage” to bring the Residency Shortage to “the table”. 

This blog was first published on Jan. 31, 2017. To use “wave” terminology, it began with a “ripple” of readers.  In 5 months, the readership has increased to a small “wave”, reaching 232 readers during the first week of July.  Here are the statistics I am going to use to set a goal for dissemination and education about the Residency Shortage via the “NoMatchMDs” blog:

2017

  • US Population – 321 million
  • Total Professionally Active Physicians in US – 923,308
  • US Congress – 535 Representatives and Senators
  • Combination of  (MDs +  Congressmen = 923,843) -  about 1 million
  • 200 million registered voters in US
Let’s visualize what it would take to reach a goal of 1 million readers of this blog, the total number of MDs and Legislators combined.  It is only through knowledge of the Residency Shortage that we can work toward a timely solution.  Here are my calculations.  If those 232 readers from the first week in July were to contact only 6 doctors or legislators EACH, and each of those contacts would make 6 contacts of their own, etc., etc.:

232 X 6 = 1,392

1,392 X 6 = 8,352

8,352 X 6 = 50,112

50,112 X 6 = 300,672

300,672 X 6 = 1,804,032

With only 5 cycles of contact, over 1.8 million people would have been reached with this information.  This is what it would take, 6 doctor/legislator contacts by each of 232 blog readers to theoretically contact “every” doctor and congressman in the US today…

This same story could extend to the education of the voting public.  If this process continued for 8 cycles, the total number contacted would rise to 390 million, almost twice the number of contacts than registered voters!

If you have followed this blog and find the cause of the Residency Shortage “compelling”, we cannot just let the message end with each one of us.  Knowledge without action is useless.  This “story” is too complex to explain it in “one sentence”.  The circumstances are many and varied.  Education of this travesty leading to a solution is the one and only goal of this blog.

At the end of each prior blog, I have asked the readers/listeners to contact the doctors and legislators in their local area to create action for the Residency Shortage.  Today, I am going to ask each of you to personally contact 6 doctors +/or legislators that you know.  Provide the link to this blog, “NoMatchMDs.blogspot”, and request that they in turn contact 6 more of their colleagues/legislators, etc., etc.  Tell them they can listen to this blog on their cell phones while commuting.  Just click on the YOUTUBE link with each blog.  Ask them to keep this “wave” going, with hopes that we will reach our goal of 1 million doctors + legislators.  Wouldn’t it be unbelievable if the cycle went 8 rounds and reached all 200 million registered voters??  It goes without saying that any “sharing” you may include in all your social media would be an added bonus.

So there we have it, a measurable goal.  Make 6 contacts each, ask your contacts to do the same and continue the cycle, and reach more than 1 million doctors and legislators in the US today.  Now that is a “TSUNAMI”!!

www.NoMatchMDs.blogspot.com
 

Tuesday, July 25, 2017

A Tsunami of Outrage/ Residency Shortage


A Tsunami of Outrage/ Residency Shortage
https://www.youtube.com/watch?v=wvXBq9P_hjw

Image result for tidal wave images free 

   Do you remember the outrage that ensued after the 2-3 hour wait times and missed flights that occurred at O’Hare Airport the weekend of May 14, 2016?  Frustrated passengers began tweeting #IHateThe Wait.  US Senator Mark Kirk, IL, called for TSA Administrator, Peter Neffenger, to fix this problem by Memorial Day or step down.  Even the White House weighed in on this travesty. (1)  By May 25th Mr. Neffenger told members of House Homeland Security Committee that the agency was taking measures to resolve this issue.  By May 24th an airline official said that O’Hare’s waits were down to 15 minutes.  That took 10 days to “fix”!

 This outrage is what has to happen to solve the current travesty of the residency shortage.  There are no “normal channels” to solve this crisis.  The Federal government is moving in typical fashion, slowly.  The first legislation introduced was “Resident Physician Shortage Reduction Act of 2011.  It was proposed again in 2013, and again by Senator Bill Nelson, FL, in 2015 (S1148) and by Representative Joseph Crowley (HR 2124) in the House.  Nothing has been passed or implemented at this point.

 This bill would increase the number of residency slots by 15,000 over a 5 year period.  We already have more that 40,000 unmatched graduates right now over the last 5 years alone!  The AMA and the ACGME have not proposed any solutions.  Only a few states have created legislation (generally applicable only to their own citizens). 

 The only glimmer of hope has been the budgetary allocations some states have made.  They have offered financial incentives to hospitals to increase residency slots or add new residencies.  This has had some success.

 Why are we not as outraged as the passengers at O”Hare Airport?  These unmatched doctors have spent more that 4 years of their lives and countless dollars trying to complete their medical training.  But they are deadlocked.  If I were they, I would gladly accept a 3 HOUR security delay in view of their own situations.

 We have to get the “word out”.  We have to tweet, blog, share on facebook, contact healthcare professionals and societies, contact legislators, and yes, even the White House!

 

(1)http://www.zerohedge.com/news/2016-05-18

http://nomatchmds.blogspot.com/

 

 
 

Tuesday, July 18, 2017


The Human Side of the Residency Shortage/
A Personal Story

 

https://www.youtube.com/watch?v=WO0QvLjLy8I

Today I am going to share with you the “human” side of the Residency shortage.  It is the story of my husband’s personal journey to becoming a doctor.

I met my husband almost 50 years ago at the University of Illinois, Champaign.  When we first began to date my “husband” told me that he planned to go to medical school and would be studying very hard.  So I had been “warned”…He needed to get “A”s in his classes in order to get into medical school.  After we had been dating for awhile, I would sometimes try to “find” him between college classes to hang out.  I knew some of his favorite libraries to study, and I would try to seek him out.  Once he knew that I might look for him, he varied his study locations so he would not get tempted to quit studying if I found him.  He was truly the most dedicated student I had ever met!  I remember that during Spring final exams one semester, he studied so hard for his physics final that he scratched the corneas of his eyes.  His hard contact lenses did not move around enough to  get lubricated while he was studying.  So he was given a doctor’s note to skip the exam and told not to study any further.  During the summers he would work on his vocabulary in preparation for the MCAT exam.  He never stopped working toward the goal of acceptance into medical school.

 But, I really remember the day he received his acceptance into medical school.  It was his 21st birthday.  His parents had called me from Chicago saying they had received his letter from the U of I Medical School and wanted to bring it to Champaign to see him open it.  They asked me not to say anything so it would be a surprise.  I held a little party at my college apartment and his parents were hiding in the bedroom.  Once the festivities began, they came out to the living room and presented their son with the letter.  We all watched him open it, and then I saw tears streaming down his cheeks….That was a momentous day in all of our lives!  It also meant another 4 years of exceedingly hard work, aiming toward the next goal, getting into a good residency program.

I would say that in the nearly 50 years my husband and I have known each other, Medicine has been at the epicenter of our lives.  It has dictated where we have lived, when, where, and how long we take vacations, etc.  My husband has always loved the Tradition of Medicine, it has a very rigid and rich protocol.  He loved the field of Medical Education and always wanted to become the director of a Residency Program, which he did.

My husband ended up taking 2 residencies and a fellowship:  Internal Medicine, Obstetrics and Gynecology, and a Gynecologic Oncology Fellowship.  That amounted to 8 years of training added to 8 years of college and medical school.

But why did I tell you this story?  I wanted you to know how traumatizing this Residency Shortage is on people just like my husband.  Just think of the devastation a fully qualified doctor graduate is feeling the day he/she finds out they did not match into a residency!  All that hard work and dedication, leading up to the last required step toward becoming a licensed physician, would have been for naught!

If you have listened to my prior blogs, you understand there is a good chance the unmatched doctors will never match into a residency in lieu of the current situation.  The extreme number of applications in today’s “Match” will favor the “cream of the crop” which has risen to the “top” numerically.  I cannot imagine the depths of despair these unmatched doctors are feeling.  I can NOT, I CAN not, I CAN NOT!

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