Your Society Makes its Mark in Washington

Fellow relays concerns of medical students to top legislator

Tina Shah, MD, MPH, a fellow at the University of Chicago, will never forget the exhilaration of testifying before a U.S. senator. Seated in the Capitol Building, across from Sen. Richard Durbin, Dr. Shah had the attention of a major legislative leader who listened as she relayed the fears of U.S. medical students and trainees. Many physicians of tomorrow, Dr. Shah stressed, wonder if they really have a future in medicine.

Dr. Shah, who was part of the Chicago Medical Society team in Washington on Feb. 23-25, gave voice to thousands of her peers. Both she and CMS President-elect Kathy M. Tynus, MD, also got a commitment from Senator Durbin that he would support the “Resident Physician Shortage Reduction Act,” a bill co-sponsored in 2013 by Senator Charles Schumer of New York, if the bill is reintroduced this year.

Because of the five-year training pipeline, Congress must raise the residency cap without delay, with funding to support existing and new programs, the two physicians emphasized. Dr. Shah gave the Senator some shocking details.

“The downsizing and closure of residency programs mean that trainees can be accepted into a program or even in their first or second year of residency, and suddenly their world collapses. For some, it’s next to impossible to get into another program,” Dr. Shah said. “There’s no algorithm for matching a person with more than a year of residency training. The match isn’t open to someone with partial training.”

Dr. Shah, a fellow in pulmonary medicine and critical care, is chair of the Resident and Fellow Section of the American Medical Association. In that role, she represents over 38,000 of her peers. She reports getting emails from young physicians about training-related issues, including abrupt program closures.

Having the ear of the Senate Minority Whip gave me “validation,” Dr. Shah says. Medical residents seldom get this kind of experience in the hospital. Lawmakers rarely talk to those in the thick of training, she observes. For Dr. Shah, speaking up is her civic duty.

In 2013, an estimated 528 graduates failed to land a residency spot. Dr. Shah cited the case of a friend in New York who was pursuing anesthesiology when her program closed during her second year. As a non-first year trainee, the friend could not fit into the match. Eventually she placed into a program, narrowly escaping having to repeat her training.

Dr. Shah also reports the case of a medical school graduate lined up to interview but the program closed without warning only a few days before the interview. Others have experienced programs shutting down even during the interviewing process.

In her own University of Chicago program, Dr. Shah said there is a clinical need for additional fellows, not to mention excellent learning opportunities awaiting such individuals. However, the lack of funding for more positions is a direct consequence of the GME cap. The shortage also increases the stress on remaining fellows, she notes.

What happens when bright altruistic young people come out of medical school, assuming they have a place to go, and find out their path is closed? Dr. Shah advises them to remember that funding is not guaranteed throughout the duration of their training.

Until reforms come to the GME system, Dr. Shah urges young members to write to their elected officials in Congress and to advocate through their professional societies such as CMS.