Medical Education: JAMA again presents a deep dive into the numbers and characteristics of learners in MD-granting US medical schools and in US residency programs accredited by the ACGME, which is now encompassing most of the programs previously accredited by the Association of American Colleges of Osteopathic Medicine (AACOM).
Regarding MD-granting medical schools: The number of medical students per 100,000 state residents is quite variable among the states which have medical schools, from a low of 11.6/100,000 in Arizona to 75.6/100,000 in Vermont. After many years of stable total enrollment of about 70,000 until 2008, the total enrollment has risen to about 86,000 in the most recent data, with close to even numbers of women and men. Fifty-eight percent of schools noted “increased difficulty finding and retaining inpatient clinical placements” for their clerkships, primarily due to competition for sites from other medical or health-professions schools.
Regarding ACGME-accredited residency and fellowship programs: From 2013-14 to 2018-19, the number of trainees in these programs expanded from about 117,000 to about 136,000. This included increases of about 1,000 international medical graduates (IMGs), about 8,000 US MD graduates, and about 10,000 US osteopathic graduates. This reviewer assumes that much of the latter increase is due to the incorporation of many programs previously certified by AACOM. Learners in these residency programs come primarily from US MD-granting schools (62.7%), DO-granting schools (14.2%), and international medical schools (23.0%). These learner types are not evenly spread among the specialties. IMGs are disproportionately represented in neurology, pathology, and internal medicine and its specialties. DO recipients are disproportionately represented in emergency medicine, family medicine, and physical medicine/rehabilitation. Among IMGs, 26% are native US citizens, 12% are naturalized US citizens, and 15% are permanent residents. The majority of the remainder are visa holders. The racial and ethnic composition of resident physicians is compared below to the composition of the US population (2010 census data per Wikipedia). From least to most represented proportionately, they are: American Indian/Alaskan native 0.11, Black 0.43, Hispanic 0.49, Pacific islander/native Hawaiian 0.50, White 0.78, Multiracial/other/unknown 1.2, and Asian 5.5. Estimates of proportions for American Indian/Alaskan native and Pacific islander/native Hawaiian are based on low numbers and likely less reliable. — Laura Willett, MD