Myth and Reality Underlying the Needed Expansion of Graduate Medical Education

The nation is facing a profound shortage of physicians. The Lewin Group estimated recently that there will be 1000–1500 too few gastroenterologists a decade from now,1 part of an overall physician shortage that is projected to reach 150,000–200,000 by 2025. If health care reform leads to a major expansion of insurance coverage, this could grow by another 40,000. To meet these needs, training capacity will have to be increased by at least one third. But because of the long lead times associated with training physicians, supply will not match demand until well after 2030, a time point that stretches ever further as action to remedy these shortages is continually delayed.