Changing Healthcare Landscape Not Slowing Drive for Med School

Now that the health insurance marketplace is open, many are wondering about the immediate effects the Affordable Care Act will have on the healthcare industry. For example, will medical degrees lose their luster? Will the financial uncertainty and politicizing of the profession discourage students from pursuing a medical degree? Will there be enough healthcare professionals to care for a growing population? At this point, the long-term financial and political implications of the healthcare overhaul, dubbed Obamacare, do not seem to be of real concern to students considering a medical career, at least not yet. Local student response bears this out as few students, if any, are asking about how the ACA will affect their reimbursement or bottom line as physicians.Jessica Clifford Kelso, a pre-professional advisor with the University of Memphis, said she hasn’t received any such questions from students or their parents. Dr. Susan Brewer, assistant dean for clinical curriculum and associate professor of medicine at the University of Tennessee Health Science Center College of Medicine, agrees. “As far as ‘will this [the Affordable Care Act] have an impact on me?’ there’s not a lot of worry,” Brewer said. “There’s curiosity.”Another indicator that students aren’t yet concerned about how the ACA will affect their futures is the number of students applying to medical school. Nationally, these numbers are off the charts and don’t appear to be slowing down, even with the dismal rollout of the ACA marketplace. According to the Association of American Medical Colleges, the number of students applying to medical school in 2013 grew 6.1 percent to 48,014, which surpassed the previous record set in 1996 by 1,049 students.Additionally, 20,055 students enrolled in medical school, which represents the first time that number has ever exceeded 20,000. The number of first-time applicants, another indicator of interest in medical school according to the AAMC, increased by 5.8 percent to 35,727.Local numbers and experiences support this. Students expressing aspirations for medical school have not diminished at the U of M, according to Kelso. Rather, such interest has increased. At the College of Medicine, medical school applications and enrollment are trending up.  “We increased the size of our medical school class a few years ago from 150 to 165, and we are filling those slots and have plenty of applicants,” Brewer said. “So there’s been no decrease in enrollment in the last couple of years. In fact, just the opposite.”The College of Medicine reports a 25 percent increase in applicants in 2012, a steady 2013 and a 5 percent increase for 2014. Additionally, Brewer said, medical schoolenrollment nationally jumped almost 9 percent in 2012 and 2.8 percent in 2013. So filling vacant slots is not a concern for most medical programs.  “Our problem is going to be a bottleneck that emerges when our current medical students ... try to get residencies,” Brewer said. That’s primarily because the number of residency slots funded by Medicare has not increased since 1997. So the concern for most students, according to Brewer, is, “Am I going to be able to match in a residency when I finish my medical degree?” That is the critical question, not how ACA will affect the student. The reason is simple.“Because without a residency, no one can practice medicine,” Brewer said.The College of Medicine is taking steps to help its students get the training they need. It has a robust counseling program in place, which is especially helpful for students pursuing a competitive residency, and the college also is engaging in public outreach to legislators to make them aware of the residency and funding shortage. While there are many challenges and uncertainties in the current healthcare environment, Brewer doesn’t think these will “scare” students away from the profession. Rather, she’s more concerned about lower-income people in Tennessee having access to healthcare. “I hope that the Affordable Care Act gets to be more affordable or leads to more affordable insurance options,” she said.