One way to alleviate the shortage of doctors…

Grant med school grads provisional licenses.


Very interesting idea reported by the Heritage Foundation

It widely accepted that the U.S. has a current shortage of doctors that is expected to balloon as the demand increases (aging population, expanded Medicaid, etc.).

Current estimates put the 2030 shortage between 40,000 and 105,000.



Each year, US med schools crank out about 18,000 medical degrees. Source

Dictated by the AMA, before getting licensed, these grads need to go through formal residency programs at teaching hospitals.

Here’s the rub.

The residency programs are largely government funded, and there are spending caps.

Spending caps translate to enrollment caps.

So, each year, about 5,000 of the med school grads — more than 25%) — don’t get a residency slot.

No residency, no license.

Reportedly, these non-residentially certified med school grads either land in non-patient treating medical jobs (think “pharma”) or leave healthcare all together.

The usual response: just throw more tax dollars at the problem.

But, there are other options…

Addressing the problem, a few states have implemented a program that Heritage is now touting: provisional licenses.


Here’s the essence of the idea:

It’s an off-shoot of the classic tradesman model.

Rather than require completion of a residency program, grant a provisional license to med school grads who have passed their Board exams

Those with provisional licenses could choose work under the supervision of a primary care physician or hospital to assist in care and acquire on-the-job training.

Details of the workload, training, and level of supervision would be documented via contract, subject to state regulation.

Over time, the supervising physician could “graduate” the trainee to more independence, commensurate with his or her experience and proven level of competence.

Eventually, the supervising physician could recommend to a certification panel that the doctor-in-training have the “provisional” qualifier removed and be licensed as a full-fledged doctor.


As Heritage points out, several benefits might be realized.

First, the residency log jam would be broken, allowing for the licensing of more doctors.

Second, while in training, the provisionals leverage the existing doctors’ pool, by taking over routine treatments … and, perhaps, providing necessary coverage in underserved areas,

And, “If done correctly, providing provisional licensure for medical graduates could open up an entirely new and competitive market for physician training, ultimately giving these graduates more choice and enabling them to receive as good, or even better, training than that available under the existing residency system”


For details, see: ”Addressing the Physician Shortage by Taking Advantage of an Untapped Medical Resource”



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