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Tuesday, September 4, 2018

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?

 (2)   Report of the Council on Medical Education, CME Report 3-A-16