# The Wrong Fix: Why America Doesn’t Need More Medical Schools to Solve the Physician Shortage

## TL;DR

The U.S. physician shortage isn't due to too few medical schools but a lack of residency training spots, which needs policy changes to fix.

## Contribution

Highlights the residency training bottleneck as the real cause of physician shortages and proposes policy reforms to modernize graduate medical education.

## Key findings

- The number of medical graduates has increased, but residency positions have stagnated since 1997.
- Unmatched graduates and inefficient resource use result from the UME-GME mismatch.
- Proposed solutions include lifting the GME cap and using AI-augmented supervision in training.

## Abstract

The United States is grappling with a physician shortage, but the solution does not lie in simply opening more medical schools. As a physician-scientist and former founding dean of a medical school, I argue that the true bottleneck is not the number of medical school graduates but the insufficient number of residency training positions. Since the Balanced Budget Act of 1997, which froze the number of Medicare-funded residency slots, the United States has seen a steady increase in medical graduates, yet the availability of residency spots has stagnated. This mismatch between undergraduate medical education (UME) expansion and the lack of corresponding growth in graduate medical education (GME) is the key issue. This editorial explores the structural flaws in the current system, particularly the artificial cap on residency slots, and critiques the recent push to open new medical schools without addressing the underlying problem in residency training. Drawing on personal experience and data, I examine the consequences of this mismatch, including the vast number of unmatched graduates, a growing physician shortage, and the inefficient use of educational resources. I propose policy reforms, including lifting the federal GME cap, creating public-private partnerships, leveraging technology for AI-augmented supervision, and adopting hybrid training models to modernize GME. Only by expanding and modernizing residency programs in tandem with UME growth can the U.S. effectively resolve its physician shortage and ensure that the medical graduates of today are trained and ready to meet the healthcare needs of tomorrow.