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Practical NeurologyAddressing the Physician Shortage: Postgraduate Licensure (PGL) for Unmatched Medical School Graduates

Postgraduate License (PGL) opportunities offer a viable solution to the growing physician shortage in the US, benefiting both U.S. and foreign medical graduates.

The physician shortage in the United States is a growing concern, with estimates suggesting a shortfall of up to 48,000 primary care and 77,100 non-primary care physicians by 2034. Although legislative efforts like the Resident Physician Shortage Reduction Act of 2021 aim to alleviate the issue, they fall short of providing a comprehensive solution. One promising avenue is the licensure of physicians who have graduated from medical school but have not matched into a residency program, known as Postgraduate License (PGL) physicians.

HCN Medical Memo
The introduction of PGL licensure offers a multi-faceted solution to the physician shortage crisis. Not only does it provide an avenue for unmatched medical graduates to gain clinical experience, but it also allows for the diversification and expansion of the physician workforce. This is particularly relevant for practices in underserved areas and for those looking to optimize costs without compromising on quality of care.

Key Points:
  • The American Association of Medical Colleges estimates a shortage of 17,800 to 48,000 primary care physicians and 21,000 to 77,100 non-primary care physicians by 2034.
  • The Resident Physician Shortage Reduction Act of 2021 aims to add 2,000 medical residency positions between 2023 and 2029 but is not a complete solution.
  • PGL licensure allows unmatched medical graduates to work under the supervision of fully licensed physicians, gaining clinical experience and contributing to the healthcare system.
  • States like Missouri, Arkansas, and Tennessee have already initiated PGL licensure, benefiting both US and foreign medical graduates (FMGs).
  • FMGs, particularly, can bring diversity and specialized skills to the US healthcare system.

The 2021 Match had a record high of 48,700 applicants for just 38,106 positions, highlighting the bottleneck in the US medical education system.

Additional Points:
  • PGLs could be a cost-effective alternative to hiring nurse practitioners and physician assistants.
  • Some states have time restrictions on PGL license renewals, but the article suggests that renewals should be allowed as long as the supervising physician endorses the PGL.
  • The implementation of PGL licensure would not cost taxpayers and would generate income for state licensing boards.

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