--- title: October 02, 2024 Residency Newsletter description: Info on -Raise ITE Scores, Fewer US Grads Choosing Pediatrics, Time to Rethink MOC, America's Growing Dependency on Foreign Doctors image: https://challengercme.com/hubfs/Untitled%20(61).png --- [![Med-Challenger-green-logo-1024x244](https://challengercme.com/hubfs/Med-Challenger-green-logo-1024x244.webp) ](https://challengercme.com/) - [SHOP EXAM PREP & CME ](https://challengercme.com/blog/october-02-2024-residency-newsletter-0#) ### [EMERGENCY MEDICINE](https://challengercme.com/emergency-medicine-exam-review-cme-course) [ABEM exam prep](https://challengercme.com/emergency-medicine-exam-review-cme-course), [MyEMCert](https://challengercme.com/emergency-medicine-myemcert-exam-review-course), etc. ### [FAMILY MEDICINE](https://challengercme.com/family-medicine-exam-review-cme-course) [ABFM exam prep](https://challengercme.com/family-medicine-exam-review-cme-course), [ABFM KSA](https://challengercme.com/family-medicine-moc-ksa-course), etc. ### [INTERNAL MEDICINE ABIM exam prep, MOC points, etc.](https://challengercme.com/internal-medicine-exam-review-cme-course) ### [OBGYN ABOG exam prep, CREOG, etc.](https://challengercme.com/obgyn-exam-review-cme-course) ### [PEDIATRICS ABP exam prep, MOCA-PEDS, etc.](https://challengercme.com/pediatric-medicine-exam-review-cme-course) ### [PEDIATRIC EM](https://challengercme.com/pediatric-emergency-medicine-3rd-edition) [ABP/ABEM exam prep Ed.3](https://challengercme.com/pediatric-emergency-medicine-3rd-edition), [Ed.2](https://challengercme.com/pediatric-emergency-medicine-pack2), etc. ### [SPECIAL PURPOSE / SPEX FSMB exam prep, etc.](https://challengercme.com/special-purpose-exam-review-spex-exam-preparation-course) ### [PHYSICIAN ASSISTANT](https://challengercme.com/physician-assistant-exam-review-cme-course) [PANCE / PANRE](https://challengercme.com/physician-assistant-exam-review-cme-course), [CAQ-EM](https://challengercme.com/pa-caq-em-review-course), etc ### [NURSE PRACTITIONER](https://challengercme.com/family-nurse-practitioner-exam-review-cme-course) [FNP](https://challengercme.com/family-nurse-practitioner-exam-review-cme-course), [ENP](https://challengercme.com/emergency-nurse-practitioner-exam-review-cne-course), [AGNP](https://challengercme.com/adult-gerontology-nurse-practitioner-exam-review-cne-course), [PNCB/CPNP](https://challengercme.com/pediatric-nurse-practitioner-exam-review-cne-course), etc. ### [NURSING / NCLEX NCLEX, CNE, etc.](https://challengercme.com/nursing-certification-nclex-exam-review-cne-courses) ### [STATE-REQUIRED CME / CE State CME requirements, etc.](https://challengercme.com/state-required-cme) ### [JOINT COMMISSION CME](https://challengercme.com/stroke-center-ce-review-course) [Stroke](https://challengercme.com/stroke-center-ce-review-course), [Cardiac](https://challengercme.com/cardiac-center-ce-review-course), [Trauma](https://challengercme.com/trauma-center-ce-review-course), [ALS](https://challengercme.com/advanced-life-support-and-resuscitation-center-ce-review-course), etc. ### [PROFESSIONALISM CME Professionalism review with CME](https://challengercme.com/professionalism-review-course) ### [DERMATOLOGY CME Dermatology review with CME](https://challengercme.com/dermatology-review-course) ### [USMLE STEP 2CK / STEP 3 USMLE exam prep, etc.](https://challengercme.com/usmle-certification-exam-review-clerkship-exams-shelf-exam-review) - [INSTITUTIONS ](https://challengercme.com/atlas-pro-inst) - [BLOG ](https://challengercme.com/blog) - [SUPPORT ](https://support.challengercme.com/knowledge) [SIGN IN ](https://fuse.challengercme.com/sign-in?redirectURL=%2Fuserdash) # October 02, 2024 Residency Newsletter Info on -Raise ITE Scores, Fewer US Grads Choosing Pediatrics, Time to Rethink MOC, America's Growing Dependency on Foreign Doctors [ Challenger Corporation ](https://challengercme.com/blog/author/challenger-corporation) Oct 2, 2024 ### < [All Posts](https://challengercme.com/blog) Try Med-Challenger Start a free trial today and save! 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[BROWSE COURSES](https://fuse.challengercme.com/store) --- ### Share this article [mailto:?subject=Check%20out%20https://challengercme.com/blog/october-02-2024-residency-newsletter-0&utm_medium=social&utm_source=email%20&body=Check%20out%20https://challengercme.com/blog/october-02-2024-residency-newsletter-0&utm_medium=social&utm_source=email](mailto:?subject=Check%20out%20https://challengercme.com/blog/october-02-2024-residency-newsletter-0&utm_medium=social&utm_source=email%20&body=Check%20out%20https://challengercme.com/blog/october-02-2024-residency-newsletter-0&utm_medium=social&utm_source=email) ### Subscribe ### Subscribe ![October 02, 2024 Residency Newsletter](https://challengercme.com/hubfs/Untitled%20(61).png)   - America's Dependency on Foreign Doctors - Raise ITE Scores - Rethinking Maintenance of Certification - Fewer Pediatricians? ![Untitled (10)](https://challengercme.com/hs-fs/hubfs/Newsletter%20-%20Customer%20Newsletter%20Graphics/Untitled%20(10).png?upscale=true&upscale=true&width=1120&height=78&name=Untitled%20(10).png) ## America is Increasingly Dependent on Foreign Doctors − but Their Path to Immigration is Getting Harder The statistics in this article are generally correct. The percentage of US citizens getting their medical education outside the US, generally Canada and the Caribbean are high, reflecting a different problem with medical education in the US. But about 25% of practicing physicians are foreign-born. H-1B visas were growing in popularity, but began turning down in the early 2000’s, a trend accelerating in the 2020’s. The current cap is 85,000. Medical school admissions in the US are at about 40% of qualified applicants. Residency slots offered in the 2023 match were 40,375 slots. [America is Increasingly Dependent on Foreign Doctors − but Their Path to Immigration is Getting Harder](https://theconversation.com/america-is-increasingly-dependent-on-foreign-doctors-but-their-path-to-immigration-is-getting-harder-229980?utm_source=hs_email&utm_medium=email&_hsenc=p2ANqtz-8vtmfb2iCQxrg4_XGi_lRqYZIBz2_KnTrs3NCZhc-Ka6ovTnmiJbth8UPLi2TuNwg6S-KK) [![Untitled (40)](https://challengercme.com/hs-fs/hubfs/Newsletter%20-%20Customer%20Newsletter%20Graphics/Untitled%20(40).png?upscale=true&upscale=true&width=1120&height=78&name=Untitled%20(40).png)![Sky Blue Pastel blurb newsletter residency](https://challengercme.com/hs-fs/hubfs/Joy%20Canva%20Graphics/Sky%20Blue%20Pastel%20blurb%20newsletter%20%20residency.png?upscale=true&upscale=true&width=1120&height=373&name=Sky%20Blue%20Pastel%20blurb%20newsletter%20%20residency.png)![Untitled (62)](https://challengercme.com/hs-fs/hubfs/Untitled%20(62).png?upscale=true&upscale=true&width=1120&height=78&name=Untitled%20(62).png)](https://challengercme.com/medical-education-lms-for-residency-training-programs?utm_source=hs_email&utm_medium=email&_hsenc=p2ANqtz--Waef_P66hy2zG_OXV6aumnnH2QZloSBrTTmq1SesOgrJ49HJ1tHssj3yhtx4yRptgWsP2) ## The Time Has Come to Rethink Maintenance of Certification From the Gastroenterology & Endoscopy News, a brief on the objections to Maintenance of Certification, at least within the realm of Internal Medicine subspecialties. But similar to some complaints across many other primary and acute care specialties: scope of practice, applicability to actual practice, cost, and no clear proof that MOC improves patient outcomes.  There aren’t any good sites or articles that detail the history behind MOC from the initial wave of specialization and certification examinations that began in the 1970’s, to the drastic increase in the pace of change of knowledge specialization in the 1990’s forward. Nor the aspects of certification that have been impacted by technology, from paper tests and paper journals, to broadcast emails, proliferation of bulletin resources and electronic journals, and gated physician specialty discussion areas. And now AI, or sort-of AI - call it ‘the best search and summarization engine humans have ever built’.  Weighted against changes to certification, MOC, and how physicians stay up-to-date within their practice of medicine are all the status quo and cash flows that derive from everything from residency applications to state-required opioid lectures. [The Time Has Come to Rethink Maintenance of Certification](https://www.gastroendonews.com/Opinions-and-Letters/Article/09-24/gastroenterology-boards-maintenance-of-certification-continuing-education/74800?utm_source=hs_email&utm_medium=email&_hsenc=p2ANqtz-8vtmfb2iCQxrg4_XGi_lRqYZIBz2_KnTrs3NCZhc-Ka6ovTnmiJbth8UPLi2TuNwg6S-KK) ## ![Untitled (63)](https://challengercme.com/hs-fs/hubfs/Untitled%20(63).png?upscale=true&upscale=true&width=1120&height=78&name=Untitled%20(63).png)Why are Fewer U.S. MD Graduates Choosing Pediatrics? The 2024 match in Pediatric residencies left 7.7% of positions unfilled, which continued a trend as the percent of slots filled has gradually declined from 95% to 92% over the last decade. The growth in positions offered in *general* pediatrics is up from 2810 in 2015 to 2900 today. The consensus for explaining the decline is lower pay rates in pediatrics, and then a host of factors including rising student debt levels and a decrease in pediatric faculty in medical schools. The complexity of pediatric specialist care is advancing as well, leading to more complex case loads and burnout. General pediatrics is the one primary care specialty that bucked the hospital buyout trend somewhat, with only around 25% of pediatric practices in the US hospital-owned or hospital affiliated, versus 45% in general adult primary care. ![peds res graph-1](https://challengercme.com/hs-fs/hubfs/peds%20%20res%20graph-1.png?width=961&height=539&name=peds%20%20res%20graph-1.png) [Why are Fewer U.S. MD Graduates Choosing Pediatrics?](https://www.aamc.org/news/why-are-fewer-us-md-graduates-choosing-pediatrics?utm_source=hs_email&utm_medium=email&_hsenc=p2ANqtz-8vtmfb2iCQxrg4_XGi_lRqYZIBz2_KnTrs3NCZhc-Ka6ovTnmiJbth8UPLi2TuNwg6S-KK) - AAMC   [ Subscribe to Our Blog & Save 15% ](https://challengercme.com/blog)   ## Similar posts ### [June 21, 2024 Residency Newsletter](https://challengercme.com/blog/june-21-2024-residency-newsletter) AI Docs in Alabama, Resolution to Make USMLE 3 Pass/Fail, IMGs Role in American Medicine, Upcoming Academic Year Challenger Corporation Jun 21, 2024 ### [September 19, 2024 Customer Newsletter](https://challengercme.com/blog/september-19-2024-customer-newsletter-0) Fixing American Health Care, UHC Criticism, Ozempic Conversation, Fair Pay for Doctors, ACG Criticizes UHC, Best Subscription Value Challenger Corporation Sep 19, 2024 ### [March 21, 2024 Customer Newsletter](https://challengercme.com/blog/march-21-2024-customer-newsletter) Patient Care in Rural America, Hackers Attack Healthcare, AI Content Enhancement, EM Review & CME Challenger Corporation Mar 21, 2024 ## Stay informed. ### Subscribe to our [Medical Education Blog](https://challengercme.com/blog)  Stay informed of new medical education content, certification requirements and deadlines, case-based CME quizzes, and special offers. 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All rights reserved [Privacy Policy](https://support.challengercme.com/knowledge/what-are-your-terms-of-service-privacy-policy-user-agreement) ```json { "@context" : "https://schema.org", "@id" : "https://challengercme.com/blog#webpage", "@type" : "WebPage", "description" : "The Challenger Medical Education Blog offers informative patient cases, medical certification exam preparation courses and board exam review tips.", "inLanguage" : "en", "isPartOf" : { "@type" : "WebSite", "name" : "Med-Challenger", "url" : "https://challengercme.com/" }, "mainEntityOfPage" : { "@id" : "https://challengercme.com/blog", "@type" : "WebPage" }, "name" : "Challenger Medical Education Blog", "primaryImageOfPage" : { "@type" : "ImageObject", "url" : "https://challengercme.com/hubfs/Webpage%20Featured%20Images/Medical%20Education%20Blog%20-%20Free%20CME%20resources%2c%20certification%20exam%20tips%2c%20clinical%20challenge%20questions%20and%20more.png" }, "publisher" : { "@type" : "Organization", "name" : "Challenger Corporation", "url" : "https://challengercme.com/" }, "url" : "https://challengercme.com/blog" } ``` ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "about" : [ "foreign medical graduates", "H-1B visas and immigration caps", "maintenance of certification (MOC)", "pediatrics workforce trends", "residency match statistics", "ITE score improvement", "exam preparation", "continuing medical education" ], "articleSection" : "Medical Education Newsletter", "author" : { "@type" : "Organization", "name" : "Challenger Corporation" }, "dateModified" : "2024-10-03T13:48:17.613Z", "datePublished" : "2024-10-02T21:45:09.000Z", "description" : "A brief residency-focused medical education newsletter covering ITE score tips, workforce trends including growing dependence on foreign doctors, debate around Maintenance of Certification (MOC), and why fewer U.S. MD graduates are choosing pediatrics.", "headline" : "October 02, 2024 Residency Newsletter", "image" : [ { "@type" : "ImageObject", "description" : "Med-Challenger Medical Education, a Division of Challenger Corporation", "license" : "https://challengercme.com/terms", "url" : "https://challengercme.com/logo.png" } ], "inLanguage" : "en-US", "keywords" : [ "residency newsletter", "medical education", "exam preparation", "pediatrics", "maintenance of certification", "MOC", "foreign doctors", "H-1B", "residency match", "ITE scores" ], "mainEntityOfPage" : { "@id" : "https://challengercme.com/blog/october-02-2024-residency-newsletter-0", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://challengercme.com/logo.png" }, "name" : "Challenger Corporation" } } ``` ```json { "@context" : "https://schema.org", "@type" : "QAPage", "mainEntity" : { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "7.7% of pediatric residency positions were unfilled in the 2024 match. This reflects a gradual decline in the percent of slots filled over the last decade (from about 95% to 92%), attributed in the newsletter to factors such as lower pay in pediatrics, rising student debt, fewer pediatric faculty, increasing case complexity, and burnout." }, "name" : "What percentage of pediatric residency positions remained unfilled in the 2024 match?", "text" : "According to the newsletter summary, what percent of pediatric residency positions were unfilled after the 2024 match and what trend does this reflect?" } } ``` ```json { "@context" : "https://schema.org", "@type" : "ItemList", "description" : "Exam-style review questions based on this article’s teaching points.", "itemListElement" : [ { "@type" : "ListItem", "item" : { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "The newsletter states that about 25% of practicing physicians in the U.S. are foreign-born." }, "name" : "What proportion of practicing physicians in the U.S. are foreign-born, according to the newsletter?" }, "position" : 1 }, { "@type" : "ListItem", "item" : { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "The newsletter notes the current H-1B cap is 85,000." }, "name" : "What is the current H-1B cap mentioned in the newsletter?" }, "position" : 2 }, { "@type" : "ListItem", "item" : { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Two objections described are cost and lack of clear proof that MOC improves patient outcomes; the newsletter also mentions scope-of-practice applicability as a concern." }, "name" : "List two common objections to Maintenance of Certification (MOC) described in the newsletter." }, "position" : 3 }, { "@type" : "ListItem", "item" : { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "General pediatrics positions increased from 2,810 in 2015 to about 2,900 at the time of the newsletter." }, "name" : "How did the number of general pediatrics positions change from 2015 to the time of the newsletter?" }, "position" : 4 } ], "name" : "Practice Questions", "numberOfItems" : 4 } ```