Graduate Medical Education and Physician Workforce Shortage

Urologists urge Congress to acknowledge the importance of specialty medicine and address urological workforce shortages that jeopardize patient access to care. We urge lawmakers to support legislation aimed at this problem, including S. 348, the Resident Physician Shortage Reduction Act (Menendez, Boozman, Schumer).

The Resident Physician Shortage Reduction Act will provide much-needed improvements to the nation’s graduate medical education (GME) system. In particular, the bill preserves access to specialty care by: increasing the number of GME residency slots by 15,000 over the next five years; directing half of the newly available positions to training in shortage specialties such as urology; specifying priorities for distributing the new slots (e.g., states with new medical schools); and studying the needs of the U.S. healthcare system to allocate residencies accordingly.

The United States will face an overall shortage of more than 130,000 physicians by 2025 and one-half of this shortage will come from specialty physicians such as urologists. Urology has seen a greater than 10 percent decline in the number of urologists per capita over the past 20 years. In 2009, there were only 3.18 urologists per 100,000 population, which marked a 30-year low in the labor force for our field. The average age of a urologist is 52.5 years, with more than 44 percent of urologists age 55 or older, making our specialty the second oldest only to thoracic surgery. In addition, training for urologists following graduation from medical school is a minimum of five years and frequently longer.

The Health Resources and Services Administration Bureau of Health Professions, in its 2008 report, projected a need for 16,000 urologists by 2020. This is congruent with other independent projections that show that by 2030 urology will face a 32 percent deficiency in the number of providers necessary to adequately care for a projected population of 364 million U.S. citizens. A recent American Urological Association (AUA) Workforce and Compensation Survey indicated that up to 20 percent of currently practicing urologists plan to retire in the next five to ten years. We must take steps now to ensure a fully trained specialty physician workforce for the future.