Fill Mid-Level Positions With Unmatched Medical Graduates


By Alice Nguy, MD

In a crowded primary care clinic in an inner city, Mr. Smith, with pursed lips, was sitting next to his oxygen tank and waiting patiently for his doctor. He gratefully commented on how much the oxygen tank had helped him with his daily activities. However, his recent Covid-19 infection had exacerbated his symptoms. It had been more than two weeks since he started coughing. He couldn’t wait to see his doctor.

Mr. Smith was not the only one that experienced a long wait. The average waiting time to see a doctor had increased to an all-time high of 28 days over the past decade. This waiting issue was partly due to the increasing demands from aging baby boomers. AAMC projections by 2034 included shortages of between 17,800 and 48,000 primary care physicians and between 21,000 and 77,100 non-primary care physicians. There are two potential solutions to help alleviate the shortage.

Our medical training system has successfully trained roughly 40,000 medical graduates yearly, which is a significant accomplishment given the sophistication of our modern medicine. The shortage is attributed to the limited number of residency positions. To tackle this issue, there has been a commendable effort to increase the number of residency vacancies.

The other viable solution is to increase mid-level positions from the untapped unmatched medical graduates. Every year the unmatched rate is about 4 to 8 percent which roughly accounts for two to three thousand candidates. If starting from this year, that number would add up to about 20,000 by 2032, which would potentially provide significant relief to our shortage issue. Furthermore, training medical providers is costly. This underutilized candidate pool accounts for at least 400 million dollars that is currently wasted yearly.

Lastly, the unmatched medical graduates are qualified to transition into mid-level positions. Their medical training exceeds the ones from any mid-level training for nurse practitioners or physician assistants. Indeed, they spend thousands of hours in didactics and on clinical rotations to gain the necessary knowledge and skills to pass the two national standardized USMLE Step 1 and 2 exams.

As our modern medicine becomes more accessible through telemedicine, the demand for quick medical care has been growing. It naturally makes sense to utilize our untapped human resources to meet medical needs.

Alice Nguy is a physician.


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