Medical Graduates Per 100,000 Population (2019): 8.1
Nursing Graduates Per 100,000 Population (2019): 65.6
Percent Share of Foreign-Trained Doctors (2019): 25.0%
Percent Share of Foreign-Trained Nurses (2019): 6.1%
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
Median Cost of Medical School Tuition at a Public Medical School, First Year Students, 2019-2020 School Year: $33,474.
Source: Association of American Medical Colleges. Tuition and Student Fees for First-Year Students: Summary Statistics for Academic Years 2012-2013 through 2019-2020. AAMC Tuition and Student Fees Questionnaire. Data as of February 2020. Last accessed March 26, 2020.
“The percentage of 2019 medical school graduates who graduated with no medical school debt was 28.7%. This is slightly larger than the 27.7% of 2018 graduates who reported having no medical school debt. The share of graduates without medical school debt has grown steadily in recent years; in 2015, the figure was 21.5%.
“For those graduating with debt, the median medical school debt reported was $200,000, an increase of 2.7% over the median $195,000 reported by 2018 graduates. For total educational debt, the sum of premedical educational debt and medical school debt, the median reported by indebted students in 2019 was $200,000, the same as in 2018. Of those carrying debt, 43.9% indicated plans to enter a loan forgiveness program. Three quarters (76.3%) of respondents planning to enter a loan forgiveness program identified the Department of Education’s Public Loan Forgiveness Program in their repayment plans.”
Source: Association of American Medical Colleges. Medical School Graduation Questionnaire. 2019 All Schools Summary Report. July 2019.
“The percentage of [medical school] graduates with education debt dropped sharply between 2013 and 2016, from 86% to 78% (Figure 1). Less than 4% of borrowers graduating from medical school have premedical debt only (data not shown), so the decrease is almost entirely due to the decline in the percentage of graduates with medical school debt. The largest annual changes in percentage of graduates with medical school debt were for the class of 2015 (down from 83% to 78%) and the class of 2016 (down from 78% to 73%).”
Source: Youngclause, J. “An Exploration of the Recent Decline in the Percentage of US Medical School Graduates With Education Debt.” Association of American Medical Colleges. Analysis in Brief, Volume 18, Number 4, Sept. 2018.
“The decline in the percentage of graduates reporting medical school debt is notable but defies easy explanation. Three variables appear to play a role. First, with the discontinuation of federally subsidized loans, graduates using only these financially advantageous loans steadily phased out of the debt data in recent years, possibly accounting for up to a quarter of the overall decline.
“Second, scholarship dollars and frequency increased in recent years, though not by enough to explain all the increase in graduates with no medical school debt. Third, the percentage of graduates from families with parental income of at least $200,000 has increased since 2010, but the percentage of such graduates among the total number with both no medical school debt and parental income data actually decreased in two key years (2015 and 2016). These two variables explain some but not all of the increase in graduates with no medical school debt.
“A fourth variable — graduates from newly accredited medical schools — did not affect the decline in the percentage of graduates with medical school debt. These graduates are a small percentage of all graduates and, in every year since 2014, have slightly higher rates of indebtedness compared with graduates from all schools.”
Source: Youngclause, J. “An Exploration of the Recent Decline in the Percentage of US Medical School Graduates With Education Debt.” Association of American Medical Colleges. Analysis in Brief, Volume 18, Number 4, Sept. 2018.
“In nursing, a major distributional issue with regard to area of practice is the low number of RN faculty in nursing education (Bittner & Bechtel, 2017). Nationally, there is an average nurse faculty vacancy rate of 7% with 58% of schools reporting full-time vacancies (Bittner & Bechtel, 2018). This shortage of nursing school faculty is restricting nursing programme enrolments and contributing to the overall nursing shortage. US nursing schools turned away 64 067 qualified applicants from baccalaureate and graduate nursing programmes in 2016 due to insufficient number of faculty and other constraints. Almost two-thirds of nursing schools report a shortage of faculty and/or clinical preceptors as a reason for not accepting all qualified applicants into their programmes (AACN, 2017).”
Source: Rice T, Rosenau P, Unruh LY, Barnes AJ, van Ginneken E. United States of America: Health system review. Health Systems in Transition, 2020; 22(4): pp. i–441.
“The NHSC [National Health Service Corps] is administered by the Health Resources and Services Administration (HRSA), within the Department of Health and Human Services (HHS). Congress created the NHSC in the Emergency Health Personnel Act of 1970 (P.L. 91-623), and its programs have been reauthorized and amended several times since then.
“The Patient Protection and Affordable Care Act of 2010 (ACA; P.L. 111-148) permanently reauthorized the NHSC. Prior to the ACA, the NHSC had been funded with discretionary appropriations. The ACA created a new mandatory funding source for the NHSC—the Community Health Center Fund (CHCF), which was intended to supplement the program’s annual appropriation. However, between FY2012 and FY2017, the CHCF entirely replaced the NHSC’s discretionary appropriation. For FY2018, the NHSC received $105 million from discretionary appropriations in P.L. 115-141 to support awards to expand and improve access to opioid and other substance use disorder treatment providers. The law also reserves $30 million from the $105 million for the new Rural Communities Opioid Response initiative administered by the Federal Office of Rural Health Policy within HRSA. For FY2018, CHCF funding represents 75% of the program’s appropriation.
“The CHCF is time-limited. Initially an appropriation from FY2011 through FY2015, the CHCF was subsequently extended in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, P.L. 114-10) through FY2017 and then extended for an additional two years (i.e., through FY2019) in the Bipartisan Budget Act of 2018 (BBA 2018, P.L. 115-123).
“From FY2011 through FY2017, the most recent year of final data available, the NHSC offered more than 39,000 loan repayment agreements and scholarship awards to individuals who have agreed to serve for a minimum of two years in a HPSA. In FY2017, the NHSC made 5,711 awards. The number of awards the NHSC makes is only one component of program size, because not all awardees are currently serving as NHSC providers; some are still completing their training (e.g., scholarship award recipients). As such, the NHSC also measures its field strength: the number of NHSC providers who are fulfilling a service obligation in a HPSA in a given year. In FY2017, total NHSC field strength was 10,179. NHSC providers are currently serving in a variety of settings throughout the entire United States and its territories. The majority of NHSC providers serve in outpatient settings, most commonly at federally qualified health centers.”
Source: Elayne J. Heisler, “The National Health Service Corps,” Congressional Research Service, R44970, April 26, 2018.
“There are two paths to gaining acceptance into a medical school in the United States. The more common and traditional method entails gaining acceptance into a 4-year university and completing a Bachelor’s degree while completing 2 years of pre-medical requirements. These requirements vary by school but most commonly include one year of biology with lab, one year of general chemistry, one year of organic chemistry with lab, and one year of physics. Some schools also require coursework in behavioral and social sciences, one year of writing/English, and up to one year of mathematics. Students must also take the MCAT as a standardized test with the purpose to assess one’s capacity for the rigors of medical school.
“Alternatively, high school students may enter a combined B.S./M.D. or B.A./M.D. program. These programs allow students to earn a Bachelor’s degree and then proceed directly into a medical program for a Doctor of Medicine (M.D.). One benefit to these programs is that students may forego the typical medical school admissions process that most pre-medical students undergo at the end of their undergraduate careers. Additionally, these programs are often in the form of accelerated 6- or 7-year programs (as opposed to the traditional 8) and most, but not all, relinquish the student from MCAT requirement.
“Application numbers to medical schools in the United States are at an all-time high and increasing every year. Most recently, 53,029 applicants applied in 2016 and 21,025 matriculated, yielding an acceptance rate of 39.6% [47]. The rate of growth in medical school positions has not matched the rate of demand, and therefore the last several years have demonstrated an average downward trend in acceptance rate with few exceptions. Studies have shown that scores on the MCAT have limited predictive validity for medical school performance and licensing exam measures [48]. With the understanding that objective measurements including test scores and grades are not sufficient to identify candidates who will go on to become competent and successful physicians, the medical school admissions process has moved toward a more holistic approach including increasing the weight of nonacademic data [44].”
Source: Zavlin D, Jubbal KT, Noé JG, Gansbacher B. A comparison of medical education in Germany and the United States: from applying to medical school to the beginnings of residency. GMS Ger Med Sci. 2017;15:Doc15. DOI: 10.3205/000256, URN: urn:nbn:de:0183-0002568
“The cost of medical school tuition in the United States has developed a reputation worldwide for being exceedingly expensive. Tuition, fees, and health insurance at public medical schools averages at $34,592 per year for residents and $58,668 for nonresidents, meaning those who are not from the same state as the school. Private medical schools cost an average of $55,534 per year for residents and $56,862 for nonresidents [59]. These figures do not include living expenses, which vary in each locale. A total of 76% of medical students graduate with educational debt [60]. Of these students with debt, the average for students graduating from public medical schools is $180,610 (median $180,000) and the average for students graduating from private schools is $203,201 (median $200,000) [60]. Additional premedical education debt, referring to undergraduate university studies, has most recently been estimated with average figures of $25,550 to $39,950 depending on college type [61]. The majority of tuition and living expenses are paid by family contribution or loans. Part-time employment is uncommon among medical students in the United States, and in many schools strictly forbidden. Few students are fortunate to receive significant scholarships to alleviate the financial burden of medical school. The significant debt of graduating medical students is considered the major burden of becoming a US physician. These costs translate to the fact that the United States operates the most expensive healthcare system in the world [7].”
Source: Zavlin D, Jubbal KT, Noé JG, Gansbacher B. A comparison of medical education in Germany and the United States: from applying to medical school to the beginnings of residency. GMS Ger Med Sci. 2017;15:Doc15. DOI: 10.3205/000256, URN: urn:nbn:de:0183-0002568
“Another decision for policymakers is whether government support for graduate medical education and for hospitals that treat a high proportion of low-income patients would continue under a single-payer system, and if so, how those payments would be structured. For example, teaching hospitals could have higher payment rates or receive compensation for their teaching costs through direct payments outside the single-payer system. Similarly, hospitals that treat a large portion of low-income patients could receive additional government support.”
Source: Congressional Budget Office, Key Design Components and Considerations for Establishing a Single-Payer Health Care System. May 2019.
“In addition to the short-term effects discussed above, changes in provider payment rates under the single-payer system could have longer-term effects on the supply of providers. If the average provider payment rate under a single-payer system was significantly lower than it currently is, fewer people might decide to enter the medical profession in the future. The number of hospitals and other health care facilities might also decline as a result of closures, and there might be less investment in new and existing facilities. That decline could lead to a shortage of providers, longer wait times, and changes in the quality of care, especially if patient demand increased substantially because many previously uninsured people received coverage and if previously insured people received more generous benefits. How providers would respond to such changes in demand for their services is uncertain. To encourage the supply of providers in the longer term, the government could more heavily subsidize the cost of graduate medical education to encourage people to continue to enter medical professions.”
Source: Congressional Budget Office, Key Design Components and Considerations for Establishing a Single-Payer Health Care System. May 2019.
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Page last updated November 10, 2023 by Doug McVay, Editor.
