In a stunning announcement that I just picked up, Raymond and Ruth Perelman have just donated $225 million to the University of Pennsylvania School of Medicine, garnering naming rights. But, more importantly, they plan for most of it to fund the students—reducing the tuition that is so exorbitantly high (for all med schools, not just Penn) as a barrier for attendance so they get the very best here in Philly @ Penn Med.
My first reaction—WOW! After I calmed down from seeing the largest single gift to a U.S. university ever, my second reaction was one of applause. Some donors completely not from the medical realm (Mr. Perelman made much of his fortune in mining perlite) have chosen to look into our issues. That's admirable, and I'm so happy for my friends at Penn Med who get to enjoy this ease on their burden.
But if you read around about this news bit (I won't go at length here) you get the sense Mr. Perelman prides himself on understanding the concerns and issues of medical education and helping it meet what the new legislation from Washington will be calling for—in simplest demands: more doctors.
What I feel Mr. Perelman misses is the problem that we as medical students are facing but that I have never seen reported outside of a medical education publication—the residency shortage. When we graduate from medical school, we move into internships and residencies in a desired specialty (cardiology, family practice, general surgery, etc.) We apply for these just like you would apply to anything academic—you've got scores, letters of recommendation, interviews, etc.
If we don't complete residency, we don't get certified by state medical boards, don't do a whole lot of other things and ultimately what's important to everyone: we don't practice.
My best current example is looking at medical school as a sink. The faucet the yearly admissions process to medical school. The drain is residency. You want that water getting down the drain—otherwise, you've got trouble my friends. It does no good to turn the faucet on more (increase class size, open new schools, etc.) if you don't make the residency slots more numerous. This leads to an overflow—of students and people with letters after their name who can't do anything.
The money for residency slots comes from The Health & Human Services Department—primarily from Medicare. So with the recent budget muck going on in DC, it hasn't been easy to ask them to fund new residencies which come in at about $35,000/yr per medical resident across the country (it's essentially our salary while we're training).
So in as short as I could possibly make it while being fair to the issue—that is the biggest medical problem you've never heard of. Let your congressional representatives and senators hear from you! Otherwise all that stuff you hear on the news—"Obamacare," Affordable Care Organizations, Tort Reform—mean nothing. We—doctors—need to be trained and certified to help you, and with more and more medical grads coming every year, we're finding it hard to do.