Debt, Demographics, and Dual Degrees: American Medicine at the Crossroads

After a quarter century of national policy guided by two principal themes-fear of a physician workforce glut and official preference for careers in primary care medicine-the Council on Graduate Medical Education in January 2005 reversed course and announced its projection of a general physician shortage by 2020 and specifically named several specialties, including radiology, in which the shortage would be most severe. In response, the Association of American Medical Colleges initially proposed that medical schools increase enrollment by 15% and subsequently by 30% over the next 10 years. In the first of 3 articles devoted to the physician workforce crisis, the market model is applied to medical services, and questions are raised about the feasibility of the proposed medical school expansion.