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.
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
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.
Why are Fewer U.S. MD Graduates Choosing Pediatrics? - AAMC