PHYSICIAN GLUT: Schools Ignore ‘Medico-Economic Reality’

      Although the number of applicants to medical schools has fallen for a second straight year, science journalist Daniel Greenberg writes in today's Washington Post that that "a long-term solution requires recognition of a medico-economic relaity: We have too many medical schools for the nation's needs." Greenberg says medical schools continue "to train and turn 'em out at a rigidly changeless pace, although rising joblessness has become a reality in the once-golden profession of medicine." And even though the American Medical Association had recommended cutting enrollment by 1998, the number of medical students rose to 66,489 in 126 schools that year, as compared with 65,497 enrollees at 121 schools in 1981. He points to the current financial squeeze many schools are facing, saying that "[s]everal schools are near bankruptcy and a couple have merged." Greenberg agrees with a Sept. 3 op-ed by Herbert Pardes, dean of the Faculty of Medicine at Columbia University's College of Physicians and Surgeons, who wrote that NIH continues to support the older biomedical research laboratories because of the "politically popular boom in health research." Greenberg says, "Why then is NIH pouring money into ramshackle laboratories? Because the expanded platoons of researchers in medical schools live off that money, even if they can't make optimal use of it in their outmoded and inadequate laboratories. Bountifully supported, research prospers while teaching scrapes for money." Greenberg predicts that some relief will come from the Balanced Budget Amendment and should be provided "because medical education is too important and fragile to be subjected to financial battering" but, "the basic problem persists: too many schools turning out too many doctors." Greenberg concludes, "Politics only timidly recognizes that reality, while the Association of American Medical Colleges, the education industry's well-heeled lobby, blithely contends that if we just end further admission of foreign-trained physicians, all will be well. Few acknowledge what's really needed: mergers, closures and fewer doctors" (9/20).