Last year, the Legislature took a huge step in addressing Michigan’s shortage of physicians and providing doctors in underserved areas.
The FY2019 budget includes funding for the MIDOCS program, a consortium of Central Michigan University College of Medicine, Michigan State University College of Human Medicine, Wayne State University School of Medicine and Western Michigan University Homer Stryker M.D. School of Medicine. MIDOCS is charged with increasing the number of medical residencies in the state, concentrating on primary care specialties the state needs in underserved rural and urban communities.
The consortium-sponsored residencies are open to medical students who commit to practicing medicine in Michigan following residency. Students receive incentives and assistance with loan repayment for practicing medicine in underserved communities.
Within 10 years, MIDOCS could produce 500 new primary care physicians working in Michigan’s underserved areas, cutting our doctor shortage by more than 50 percent.
The Association of American Medical Colleges predicts the nation will face a shortage of between 46,000 and 90,000 physicians by 2025. The demand on health care increases as the nation’s population continues to age. Michigan in particular faces a shortage of primary care doctors, psychiatrists and orthopedic surgeons.
Students, as they near the completion of medical school, must decide what field of medicine they wish to practice. Too often, that decision is steered by debt. The AAMC reported that the average medical student debt for 2016 graduates was $190,000. A 2016 nationwide survey of physicians found that one-third of emergency medicine and family physicians are still paying off education loans.
Medical education does not end with medical school. Graduates must enter a training residency, which can last from three to seven years, depending on the specialty. If a newly graduated physician cannot secure a residency, he or she will not be able to practice medicine.
There is fierce competition nationwide for a limited number of residency slots each year. The federal government, through Medicare, pays for residencies. However, the resident count was effectively capped by the Balanced Budget Act of 1997, limiting the number of doctors the nation’s teaching hospitals train. Congress has not approved an increase in funding since 1997, so any new slots must be funded by other agencies.
As the demand for doctors increases in Michigan, it is more important than ever that the State of Michigan fund residencies that will train future physicians in Michigan. History indicates that residents who train in Michigan tend to remain in the state to practice medicine.
Thanks to Gov. Gretchen Whitmer for including funding in the FY 2020 budget recommendation. We are hopeful the Legislature will do so as well.
MIDOCS is a forward-looking strategy to address the state’s physician shortage and bring much-needed medical care to our underserved areas.
George Kikano, M.D. Dean, Central Michigan University College of Medicine
Norman J. Beauchamp Jr, M.D. Dean, Michigan State University College of Human Medicine
Jack D. Sobel, M.D. Dean, Wayne State University School of Medicine
Hal B. Jenson, M.D., M.B.A. Dean, Western Michigan University Homer Stryker M.D. School of Medicine