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Medical Schools Losing Allure

September 05, 2003|Steve Hymon and Stuart Silverstein | Times Staff Writers

The number of applicants to the nation's medical schools has fallen for the sixth straight year, according to a new study -- a trend that baffles researchers.

In 2002, about 22% fewer medical school applications were filed than in 1997, according to the report published Thursday in the Journal of the American Medical Assn. That translates to a drop of about 9,500 applications.

Dr. Barbara Barzansky, a co-author of the study, can't explain the drop-off. The number of applications tends to wax and wane in cycles -- or at least it has in the last 30 years, Barzansky said. A similar downturn occurred in the late 1980s and early 1990s, followed by an upswing and now the current slump. But she can't say what fuels the cycles.

Some educators and practicing physicians, however, cite a variety of factors including the plummeting prestige of doctors, the specter of enormous medical school debt, the rise of managed care and the lure of other careers perceived as less difficult or more promising.

Scott S. Kinnes, a biology professor at Azusa Pacific University in the San Gabriel Valley, said the students he advises often are dropping the idea of applying to medical school and instead are pursuing related lines of work, particularly careers as physician assistants.

"It's a nice compromise for a lot of these students," Kinnes said.

Kinnes said the rising profile, prestige and salaries of physician assistants, and the challenge of getting into a medical school, force many hands.

Barzansky does not, however, believe the numbers portend a looming doctor shortage.

" ... There are still two applicants for every position in medical schools, and the academic quality of people applying to schools hasn't changed," Barzansky said.

The sag in applications appears to be less dramatic in California, home to many of the nation's most prestigious and well-known medical schools.

For example, admission officials at the USC Keck School of Medicine have seen no drop in recent years. Anywhere from 4,000 to 5,000 students have applied for the school's 160 seats.

There has been a slight dip at UC San Francisco's School of Medicine, from about 5,000 applicants a year in the late 1990s to 4,500 this year. UCLA's Geffen School of Medicine saw a similar decline, from about 5,800 applicants to 5,250 this year.

Numbers at the UC Davis School of Medicine haven't changed much over the last three years, school officials said. Applications have fallen from 3,741 in 2001 to 3,635 in 2003.

Dr. Clayton Patchett, 52, a Pasadena orthopedic surgeon, said the numbers didn't surprise him.

Patchett's father was a doctor. His sister is an anesthesiologist. His twin brothers are both ophthalmologists.

But Patchett has two daughters, both undergraduates in college. One wants to be a veterinarian, the other is interested in international business.

He sees an array of factors driving people away from the medical field, from the annoyance of patients who misdiagnose themselves on the Internet to salary concerns and loss of stature with the arrival of managed care.

"We're not the knights in shining armor that we used to be," Patchett said. "We'll talk to residents here with $120,000 in debt from medical school, and the first patient they see says, 'I want a second opinion because my plumber said you're wrong.' Then the plumber comes to my house to fix something and he gets paid more than I do."

At Pomona College in Claremont, the number of students applying to medical school has hovered at about 55 for the last several years, down from a peak of about 65 in the mid-1990s.

On the other hand, said Richard S. Lewis, chair of the medical sciences committee at the college, those students who still want to become doctors "seem to be going to medical school for the right reasons. They seem to be genuinely interested in serving people who are in unfortunate situations. There's clearly a resurgence of interest in helping the underserved."

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