JAMA : the journal of the American Medical Association
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To describe the current status of medical education programs in the United States, we used data from the 1997-1998 Liaison Committee on Medical Education Annual Medical School Questionnaire, which had a 100% response rate, and from other sources. There were 96733 full-time medical school faculty members, a 1.2% increase from 1996-1997. ⋯ More than half of medical schools reported that the number of inpatients available for medical student education had decreased in at least some of their clinical sites or in some disciplines during the past 2 years. Thirty-nine medical schools (31.2%) reported having more difficulty recruiting or retaining volunteer clinical faculty to participate in medical student teaching in 1997 than in 1995.
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Previous studies have found that fewer minority medical school faculty hold senior professorial ranks than do majority faculty and may not be promoted as rapidly. ⋯ Minority faculty were less likely than white faculty to hold senior academic rank. This finding was not explained by potential confounders such as years as a faculty member or measures of academic productivity.
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Studies analyzing the physician workforce have concluded that the United States is verging on a physician oversupply, yet we lack persuasive evidence that this is resulting in physician underemployment and/or unemployment. ⋯ Resident physicians' direct reports of their employment-seeking experiences differ from what program directors report. Program directors accurately determined the number of residents pursuing further training; however, they did not have complete information about the employment difficulties experienced by their graduates. Based on graduates' reports, we conclude that employment difficulties are greatest among international medical graduates and vary by specialty and geographic region.
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In response to growing concerns that continued unlimited governmental funding of graduate medical education (GME) would lead to a physician surplus, Congress enacted provisions in the Balanced Budget Act (BBA) of 1997 to limit further growth, as well as to encourage reductions in GME. The measures incorporated in this section of the BBA reflect recommendations made by a number of major professional associations. The question now is how effective these efforts will be and whether they will produce unintended or deleterious consequences. ⋯ The number of residents entering GME programs without prior GME experience has also remained constant; however, over the same period, the number entering a new program with some prior GME experience has fallen by 5.8%. The number of international medical graduates in all GME programs has increased 12.4% during this same period, while the number of US allopathic medical school graduates has decreased 4.4%. As federal and state initiatives are introduced to change the number and distribution of GME positions, it is critical that the American Medical Association and other professional organizations monitor GME tracking data more systematically and accurately than ever before.