A Solution for the U.S. Doctor Shortage and the Medical School Bottleneck

A Solution for the U.S. Doctor Shortage and the Medical School Bottleneck
AP Photo/Gerry Broome

Tens of thousands of Americans apply to U.S. medical schools each year. Only a fraction gain admission. The University of Arizona, for instance, posted a 1.9 percent acceptance rate in 2018. UCLA, Florida State University, and Wake Forest accepted fewer than 3 percent of applicants.

International medical schools are America's best hope for addressing its physician workforce needs. They're a crucial alternative for the thousands of qualified students who find themselves on the wrong end of a med school admissions decision as a result of the mismatch between qualified applicants and available seats.

Applying to med school has seemingly become a numbers game. In the 2018-2019 cycle, U.S. medical schools received over 850,000 applications from nearly 53,000 students. The average student applies to 16 schools.

Applicants are casting a wider net because schools are forced to turn so many students away. For example, the top ten primary care programs at U.S. medical schools cut their acceptance rates in half between 2006 and 2016.

Many students who would make terrific doctors fall through the cracks. In a recent interview with U.S. News and World Report, Dr. Robert Hasty, the founding dean and chief academic offer of the Idaho College of Osteopathic Medicine, said, "We hear from high-quality applicants every day . . . and these are people with really high MCAT scores and GPAs, that this is their second year, third year or even fourth year applying to medical schools. And years ago, they would have gotten accepted the first time through, but the demand is just incredible."

In other words, the status quo is failing thousands of highly qualified applicants -- and the U.S. healthcare system, which sorely needs more doctors.

U.S. medical schools don't appear capable of growing to address this problem. Enrollment is up only 7 percent over the past five years. And that represents an increase of just 6,000 additional doctors-to-be. That kind of modest growth won't get us anywhere close to narrowing our nation's projected six-figure shortage of physicians.

Or take the well-publicized moves by a few U.S. medical schools to go tuition-free. That's great news for the students lucky enough to gain admission. But the funds covering tuition for these fortunate few might have more impact if they went toward expanding schools and enrolling more students, given the size of the physician gap.

International medical schools can address these issues, providing opportunity to talented students and supplying the physicians America needs.

Many international schools provide an education every bit as good as those offered by U.S. schools. For example, 96 percent of first-time test takers from St. George's University in Grenada -- the school I lead -- passed Step 1 of the U.S. Medical Licensing Exam in 2018. That's the same rate as graduates of U.S. medical schools.

Research suggests that international schools, on average, produce high-caliber doctors. According to one study published by the BMJ, a leading medical journal, patients treated by doctors trained overseas had lower mortality rates than those treated by U.S.-educated doctors.

Internationally trained doctors also tend to practice where the U.S. healthcare system needs them most. In areas where per-capita income is below $15,000 annually, more than four in ten doctors received their degrees abroad. Compared to domestically educated physicians, international graduates are also more likely to care for Medicare patients with more complex health needs, according to researchers at Massachusetts General Hospital.

Americans are increasingly turning to international schools. More than 60 percent of licensed medical graduates of international schools in the Caribbean are U.S. citizens. Three-quarters of the medical students at St. George's are U.S. citizens.

The odds of gaining admission to U.S. medical schools are growing longer. But bright young Americans don't have to give up their dreams of becoming doctors. They can turn to top-notch international medical schools. Their future patients will surely thank them.

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