[Bonnevie]

Originally Posted by golfing eagles

Thank you for the update---my info is about 10-12 years old.
The 129,000 number was just what we were told in 1978, it may have included non-US citizens, or been inflated to emphasize the competitiveness of the process, so my apologies
According to your own citation, medical school applicants dropped from 47,000 to 32,000 from 1996 to 2003--but yes, those numbers have since rebounded
It did not state whether "residency programs" also included fellowship programs. Since many fellowships went from 2 to 3 years, the number finishing each year declined by 33%. In addition, about 50% of medical school graduates are now women, and that is great---however, women physicians tend to work less hours and have career interruptions for maternity leave, numbers alone don't tell the whole story

I still question the qualifications of new applicants. MCAT scores have declined. The pass rate on NBME pat I is now down to 85%---a test that my dog could pass( yes, that's a hyperbole). I sat on the admissions committee at SUNY and we had applicants with 2.3 GPAs and 35 on the MCATs---so not all "applicants" are created equal

Now, that takes care of new physicians, and your numbers are accepted. It does not include the accelerated attrition of existing physicians. The AMA estimated that as many as 250,000 current clinical MDs out of 900,000 will be lost to alternative careers and early retirement over the next 5 years. And the demand will only go up. In addition, more physician time is spent on documentation and regulation, so the number of hours in direct patient care has declined, per physician

I love nurse practitioners, but there is a pitfall there also. NPs, on average , will order far more lab tests and imaging procedures for the same condition than an experienced MD would. This drives up cost. They do spend more time with each patient, but therefore see less numbers, so you cannot substitute them for MDs 1 for 1.

So regardless of some of my inaccurate or out of date numbers, I stand by my opinion that the quality of medical in the US is going to go down, not up.

your observations mirror mine having worked in hospitals for over 30 years and seeing the caliber of graduates decrease over that time.

I appreciate your informed insight.