The College Fix

Some students going overseas to study medicine, scholar says

U.S. medical schools are not producing enough doctors despite a growing need for medical care by an increasingly aging population, a new report reveals.

The report “Why Don’t U.S. Medical Schools Produce More Doctors?” blames the Association of American Medical Colleges and American Medical Association for “slow-walking” efforts to increase enrollment.

Author Jay Greene, a Heritage Foundation senior research fellow and former professor at the University of Arkansas, told The College Fix in a recent email that foreign-educated doctors are partially filling the gap, but there are problems with that as well.

“Medical training and the healthcare system are heavily subsidized by taxpayers,” he told The Fix. “Those systems should not be creating opportunities for people overseas while driving out U.S. citizens.”

His research found “about a third of foreign-trained ‘medical residents’ are U.S. citizens who had been turned away from domestic medical schools and have been forced to go overseas.”

In connection, the report also found the number of foreign-educated doctors in the U.S. has “skyrocketed” in recent decades. The percentage of doctors trained in the U.S. went from 91 percent in 1981 to 75 percent in 2024. Meanwhile, the percentage of foreign-educated doctors went from 9 percent to 25 percent, according to the report.

The report pointed back to 1980 when the U.S. “medical establishment” expressed fears about a surplus of doctors. This led to the AMA and AAMC enforcing restrictions on medical schools’ enrollment that “remained in place until 2005.”

Despite loosening restrictions, however, the rate of doctors graduating from medical schools rose only 34 percent between 2005 and 2024, according to the report.

“The net effect of freezing and then slow-walking the expansion of allopathic medical schools is that today, 5 percent fewer M.D.s are produced each year per 100,000 people in the U.S. than in 1981, declining from 6.07 new M.D.s per 100,000 in the population in 1981 to 5.78 in 2024,” according to the report.

Spokespersons for both the AAMC and AMA declined to comment about the report’s findings when contacted by The Fix.

Reasons for the shortage

Major medical organizations also believe there is a physician shortage problem.

A March report by AAMC found a large portion of physicians are nearing retirement age. Physicians who are 65 and older were 17 percent of the active workforce in 2021, and those ages between 55 and 64 made up another 25 percent, according to the report.

As a result, the AAMC predicts “more than a third of currently active physicians will retire within the next decade.”

Both AAMC and AMA attribute the shortage to a lack of new residency opportunities; however, according to Greene’ report, the “number of residencies offered has expanded faster than the domestic production of new doctors since 1981.”

Greene told The Fix he believes there are other reasons for the shortage as well.

“A huge emphasis on diversity goals in medical schools is also making it a lot harder for students who aren’t in preferred categories,” he said. “This is causing many more qualified U.S. students to go overseas for their medical training, which is very inefficient and burdensome.”

At the same time, he said cultural values also should be considered regarding where American doctors train.

“… at a certain point the share of foreign doctors gets so high that the values and priorities of the medical profession will begin to resemble those of other countries more than the U.S.,” he told The Fix.

“Healthcare is not a value-neutral occupation and we should be careful to ensure that foreign-trained doctors are adopting U.S. values and priorities rather than altering them,” Greene said.

The number of physicians produced by American medical schools has been a topic of debate for years.

A 2020 report by American Enterprise Institute senior fellow James Capretta expressed caution about the AAMC’s projected “shortfall” of as many as 121,000 physicians by 2032, noting medical associations’ past worries about too many doctors in the 1980s and ‘90s.

Capretta, who pointed The Fix to the report when contacted for comment recently, found the ratio of physicians to Americans has risen nearly 50 percent since 1980. Still, the ratio is lower than other high-income countries like Germany, France, England, and Canada, his report found.

Solutions to the problem

To address the shifting need for physicians, Capretta’s report advocates for less government involvement in the “structure that controls the physician pipeline,” including state medical boards that “establish the criteria that must be met before physicians are issued licenses.”

Instead, medical schools should have the ability to “be flexible and adaptive enough to respond to signals of greater patient demand for access to care,” the report states.

Meanwhile, Greene’s report pointed to the U.S. “accreditation cartel” as a key problem, saying it “has been limiting the creation and expansion of U.S. medical schools” and “is the primary cause of America’s shortage of domestically trained physicians.”

Congress could change the situation by “restor[ing] control of higher education accreditation to the states,” according to Greene.

Other recommendations include offering accreditation to medical schools in Mexico and the Caribbean if they relocate or open branches in the U.S.

The AMA also has offered proposed solutions to train more doctors in the U.S.

In a November article about the “physician shortage crisis,” the association recommended that Congress expand residency training programs and student loan support for medical students. It also called for increased Medicare payments to doctors and more mental health accommodations for medical students.

MORE: Philly med school will pursue ‘diverse workforce’ through scholarships, special programs

IMAGE: New Africa/Shutterstock

Like The College Fix on Facebook / Follow us on Twitter