Report: Texas residency slots not keeping up
with medical school graduates

posted 04.26.12

A new report released April 25, 2012, reveals a severe problem in addressing the Texas physician workforce shortage: Though more medical students are graduating from Texas medical schools, Texas doesn’t have enough first-year residency slots to keep them in the state to complete their training.

The Texas Higher Education Coordinating Board finds that while Texas medical schools have increased their enrollment by 31 percent from fall 2002 to fall 2011, at least 63 graduates will not be able to enter a Texas residency program in 2014. And without further action, this shortfall will reach 180 by 2016.

According to THECB and reported by the Texas Tribune, Texas had more than 550 residency programs in 2011 that offered a total of 6,788 residency slots. By 2014, Texas will need 220 more PGY-1 residency positions to achieve the optimal 1.1 to 1 ratio of first-year residency positions to Texas medical school graduates. 

Beyond the physician shortage, the report identifies economic implications. Texas currently provides $168,000 in instruction and operation formula funding to educate each medical student over the course of four years, and research shows that the location of residency training is highly predictive of where physicians ultimately decide to practice. If, by 2016, the 180 new medical graduates are forced to leave the state for residency, that’s $30.2 million annually that will not benefit the state.

The report recommends that the Texas Legislature provide an additional $11.7 million in funding in the 2014-2015 biennium to support 10 percent of the cost for new PGY-1 residency training positions, “if funding is available.” This would support the addition of 220 first-year entering residency positions that would be needed beginning in 2014.

“What the study does not address is whether Texas’ medical schools and GME programs are producing the appropriate specialty mix to care for Texas’ growing population,” says Tom Banning, TAFP CEO.

It is widely acknowledged that patients with ready access to primary care receive more timely and optimal health care services with better outcomes. And primary care physicians provide preventive, coordinated, and continuous care that results in less invasive and costly medical intervention and reduces the probability of redundant or unnecessary services. However, “all regions of Texas have fewer primary care physicians than other physician specialties,” according to the report.

Banning continues, “We should be asking policymakers whether there should be some accountability for the type of physicians we are producing. Can Texas provide incentives to produce more family physicians and other primary care specialists?”