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Funding cuts imperil doctors’ development

Years ago, the Association of American Medical Colleges, the American Medical Association and the Committee for Graduate Medication Education predicted a critical shortfall of physicians in the U.S. by 2020 thanks to an increased demand for medical care by an aging population; retirement of the current baby boomer physician workforce; a trend toward shorter work weeks by physicians; and a persistent shortage of primary-care physicians, particularly in rural and economically depressed areas of the country.

This alarming assessment was a call to action for the Indiana University School of Medicine. In 2006, the school proposed to expand its medical student enrollment by 30 percent by 2012.

Today, I’m proud to say that the IU School of Medicine has played a role in curbing the physician shortage and addressing Indiana’s needs. This year’s entering class has 335 students, compared to 280 when the expansion plan was framed.

Unlike previous years, when the majority of the students studied at the Indianapolis campus, 60 percent of those students are attending one of our eight medical education centers around the state. Our research shows that by training more students at our medical education centers, they will pursue primary-care careers and choose to practice in small communities.

IU School of Medicine-Terre Haute has served as a model for the expansion of class size and providing clinical training to third- and fourth-year students outside Indianapolis. The Terre Haute center, in collaboration with Union Hospital, the Lugar Center for Rural Health and the Area Health Education Center, implemented a rural medicine curriculum.

The first cohort of eight students graduated in May; they all entered primary-care residencies.

While we’re clearly making strides, increasing the number of physicians graduating from medical schools solves only part of the problem.

After four years of medical school, these new physicians must complete residency training in their area of focus (family medicine, pediatrics, neurology, etc.) before they can practice medicine. Thus, there must also be a similar increase in residency positions to truly meet the need for additional physicians.

Unfortunately, federal officials have proposed cuts to residency training programs, which has been overshadowed by the daily politics of health care reform. The Association of American Medical Colleges is doing its best to make this issue more visible. It supports a 15 percent increase in residency training positions, which would prepare another 4,000 physicians each year.

I applaud the dedication of my IU colleagues and our partners throughout the state in their efforts to expand the opportunities for medical education in Indiana. I hope the expansion is met by Congress with the steps necessary to provide the post-graduate training slots required.

Dr. D. Craig Brater is dean of the Indiana University School of Medicine and vice president of University Clinical Affairs at Indiana University. He wrote this for Indiana newspapers.

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