I've been considering the
implications behind this one since my wife mentioned it.
The annual ritual of Match Day is
anticipated with excitement and fear by 4th year medical students throughout
America. Medical school is only the
beginning of a physician's training; there almost always is an internship
and/or residency to be served. How the
newly-minted physician is matched to his or her post-graduate training program
has a major impact on various life decisions, including but not limited to the
nature of the physician's practice, the finances, and, quite often,
geographical location.
If the 4th year medical student
has a significant other, then the situation is complicated all the more; this I
know firsthand, and, without getting too deeply into the specifics, will state
that the geographical and financial issues of my then-fiancee's career impacted
my own. Our courtship and marriage
continues to be a very viable item after thirty years, but not everyone is so
lucky; the marriage between one of my law school classmates and one of my
wife's med school classmates did not survive the medical residency period.
So looking at the numbers for this
year's Match Day, we had 30,212
physicians competing for 41,334 residencies, a match rate of 73%. Yes, it is true that some additional
residencies will materialize, so the unsuccessful contenders are not yet
totally out of luck (and some will go for a PhD or find some other gainful
activity). But let us look at what the
numbers tell -- and do not tell.
Behind the official Match Day
numbers are physicians who are saddled with debt for their educations. Those physicians who matched will have some
stream of income and will be able to at least make a small dent in their
educational debts. Those who did not
match and who are unsuccessful in finding gainful employment, however, will find
themselves in some very trying circumstances financially.
The foregoing verbiage is
applicable today, was applicable when my wife did her residency match, and was
applicable even a generation before, when my uncle did his residency match
which sent him out of town. Today,
however, there is a new spin on the Match Day numbers, a spin that Uncle
Leonard knows not from his own direct experience, but from the experience of his
granddaughter, who this year was fortunate enough to get matched with the residency
program that was her number two choice.
Not reflected in the numbers is
the fact that the cost of a medical school education -- like any other
collegiate educational program in America -- has been rising at a far, far
faster rate than the consumer price index.
Not reflected in the numbers is the fact that more and more
foreign-educated physicians are entering the game in America.
Not reflected in the numbers is
the fact that hospitals and other health care facilities are under pressure to
reduce their costs, and so, functions formerly performed by physicians are now being
done by others, most notably Physician Assistants and Nurse Practitioners. To be sure, there is much to be said for a
competent PA or NP; my wife speaks quite highly of those in her own department
at the hospital where she works. But in
too many instances, the PAs and NPs are being given too long a leash, and are
making decisions without the benefit of a full medical perspective.
And, of course, there is the
misnamed Affordable Care Act, which has created a demand for healthcare without
actually increasing the supply. If not
before, then by the time a student has sat in the classroom for his or her Economics
101 course, then he or she should fully appreciate that as demand increases
relative to supply, price increases.
I shall leave it to the
economists and statisticians to give detailed analyses of the match
numbers. All I ask of you now, dear
reader, is to remember that the Match Day statistics you read are all part of the
big ObamaCare train wreck, and must accordingly be viewed in that context.
The Passover holiday will soon be
upon us; wishing all a happy and meaningful one.
Labels: health care, Match Day, medical training, Obamacare
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