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Replenishing Florida's Physician Pool

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Contributed to Orlando Medical News By G. Richard Olds, MD

Florida desperately needs more doctors. By 2025, the Sunshine State will suffer a shortage of 7,000 physician specialists. This deficit will be most acute in family medicine, psychiatry and general surgery.

The state isn't doing much to prevent this crisis. Florida currently sponsors fewer residency positions per capita than almost any state. Unless officials fund more residency slots at Florida hospitals to train new doctors, tens of thousands of Floridians could soon go without adequate medical care.

This dearth of medical talent isn't unique to Florida. The nation will be short nearly 105,000 physicians by 2030, according to the Association of American Medical Colleges.

What sets Florida apart, however, is how little the state is doing to prevent the crisis. Physicians tend to stay close to the area where they train as residents. In fact, 59 percent of physicians who complete a residency in the Sunshine State remain here after their training ends.

So expanding residency slots is the most straightforward way to grow Florida's physician workforce.

Yet residency opportunities remain extraordinarily limited. Florida ranks 41st in the nation for the number of residency programs per 100,000 people. Residency openings for internal medicine totaled a mere 482 last year -- compared to 1,500 in New York.

To be sure, state institutions have added some residency slots in recent years. Only 319 recent medical graduates matched for residencies in South Florida four years ago. Roughly 500 did so in 2017.

Yet this modest uptick isn't nearly sufficient to fill the looming doctor gap. State hospitals would need to add 1,360 residency openings to stave off a physician shortage. Such a dramatic expansion of residency slots needs to begin immediately.

Training more primary care physicians is of particular importance. Florida will be short nearly 5,000 primary care doctors by 2030.

Rural Floridians will suffer immensely as a result. As former state Rep. Matt Hudson, R-Naples, put it, "If you live in one of our 32 rural counties, being able to just call a doctor and set an appointment may be something that you can only dream of in a few years."

Doctors educated at international medical schools could help satisfy Florida's growing demand for physicians.

Compared to their American-trained counterparts, international medical graduates are considerably more likely to pursue primary care. Last year, seven in 10 selected a residency in family medicine, internal medicine or pediatrics. Fewer than four in 10 domestically trained graduates did the same.

Graduates of foreign medical schools also flock to rural areas. One in five primary care doctors practicing in rural America was trained outside the United States.

Florida's hospitals have a reputation for welcoming foreign-educated doctors, many of whom are American citizens born and raised in the United States. In 2016, Florida hosted more international medical graduates than any state except New York, Michigan and Pennsylvania.

Many physicians trained at the institution I lead, St. George's University School of Medicine in Grenada, accept residencies in Florida. In 2017 alone, 36 St. George's graduates secured residency positions throughout the state.

Nevertheless, the overall lack of residency positions means Florida continues to turn away qualified new doctors. Many of the more than 500 Floridian students at St. George's end up completing their medical training elsewhere -- chiefly in New York and New Jersey -- because there aren't enough residencies for them in their home state.

Expanding the number of residency slots at state hospitals would help solve the doctor shortage before it endangers Floridians

Richard Olds, MD, is president of St. George's University (www.sgu.edu). Prior to joining SGU, he was the Vice Chancellor for Health Affairs and Founding Dean of the School of Medicine at the University of California, Riverside.



 
 
 
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