With a record-breaking number of fourth-year medical students being matched in residency programs, it would seem strong financial support for medical education has never been more necessary. Residency programs have struggled for years with their funding, leading the state to create a special fund in the 1990s to help hospitals shoulder the added expenses of training a new class of physicians. To cope with the aging population and a shortage of primary care physicians, residency programs have been growing nation-wide. According to the National Resident Matching Program, there were 1,200 more positions for residency this year than five years ago. Dr. Kathleen Watson, associate dean for students and student learning, said the UniversityâÄôs land grant mission means the Medical SchoolâÄôs first responsibility is to train physicians for Minnesota. About half the medical students usually remain in Minnesota for their residency. Dr. Frank Cerra, senior vice president for health sciences, told The Daily in January Minnesota is facing a shortage of physicians in fields such as primary care, dental and mental health. Despite this, funding for medical education of residencies by Medicare is falling, he said. âÄúEverybody wants the next generation of doctors and nurses, and nobody wants to pay for their education,âÄù said Cerra. Unfortunately, federal and state support for these programs, mostly determined by Medicare and Medicaid, hasnâÄôt mirrored that rate of growth, said Diane Rydrych, assistant director of health policy for the Minnesota Department of Health. Minnesota created the Medical Education and Research Costs fund in 1998 to help hospitals with training programs that put them at a financial disadvantage. ItâÄôs more expensive for hospitals to take in residents, Rydrych said, because they see fewer patients, often work slower and require more oversight. âÄúThere was a sense in the mid-90s that it was becoming harder to support residency,âÄù she said. âÄúThatâÄôs why MERC was created, and gives out millions of dollars each year.âÄù Facing billions of dollars in deficit, Governor Tim Pawlenty unallocated some of the funds for MERC in the current biennium, Rydrych said, but it would appear the funding will only be reduced for one year, and eventually be restored. Last year, MERC gave out $50.3 million in grants to residency sites around the state. The University of Minnesota Medical Center, Fairview received the second largest amount last year, she said, around $7.4 million.
âÄòI just wanted that answerâÄô
After four years of medical school, students apply for residency programs all over the country. A national match program determines where they will complete their training. Based on what specialty the student wishes to pursue, he or she may apply to a handful of schools, or dozens, said Scott Davenport, residency and match coordinator. Following a series of interviews, the students rank the programs and the programs rank the students. Then the information is all entered into a big computer database that pairs students with programs, weighting the student preference, said Davenport. The match is binding, and students are obligated to attend the program they are matched at. According to NRMP, 15,638 U.S. medical students applied to be matched this year. About 95 percent of them matched, and more than half matched to their first choice. The University of Minnesota medical students all learned their fates together, in a special Match Day ceremony last week. Andrea Westby, a fourth year medical student specializing in family medicine, said she was shaking waiting to tear open her match letter. âÄúI just wanted that answer,âÄù she said. âÄúAnd it was great to see exactly what I was hoping to see.âÄù Westby matched to her first choice, the United Hospital family medicine residency program in St. Paul. Months of âÄúwhat-ifâÄù conversations for fourth-year medical student Amy Kanallakan and her husband Adam, ended with the residency match announcement. She had aimed high with her residency choices, she said, and she matched with her top choice, the University of Colorado School of Medicine in Denve r, where sheâÄôll specialize in pediatrics. For Rebecca Trotzky-Sirr, a fourth-year medical student specializing in family medicine, the struggle of public hospitals to support training programs means sheâÄôll earn a lower relative salary than her classmates headed to private hospitals and clinics. Trotzky-Sirr matched to the family medicine program at Harbor-UCLA , her second choice. Even though it wasnâÄôt her top choice, she says she was drawn to the programâÄôs commitment to social justice. âÄúIt does require a financial investment from the state and we as young physicians are meeting that investment,âÄù she said. âÄúBut we donâÄôt have the financial resources to carry the whole balance on our shoulders.âÄù âÄî Emma L. Carew is a senior staff reporter.