I am most pleased to welcome Panayiotis Varelas, MD, to the AUPN as the newly appointed Bender Endowed Chair of Neurology at Albany Medical College. Dr. Varelas received his medical education at the University of Athens, after which he became an officer in the Greek Air Force, before completing a research fellowship at Baylor College of Medicine, a residency in Neurology at Yale and a Neurocritical Care Fellowship at Johns Hopkins. He previously served at Wayne State University College of Medicine as professor, and as the founder and Director of the Neurocritical Care Unit at Henry Ford Hospital. He is an officer and board member for the Neurocritical Care Society, as well as an international authority on brain death, serving as one of the key authors of the AAN’s recent consensus guidelines on that subject. Please join me in congratulating Dr. Varelas and in welcoming him to the AUPN.
The AAMC released a study in 2020 projecting a shortage of 50,000 to 140,000 physicians within the next 12 years. The AAMC foresaw this coming crisis many years ago and, in 2006, called on medical schools to increase first year enrollment by 30%, while also calling for an increase in federally funded residency slots to accommodate this increase in graduating medical students. State governments responded by expanding classes and building a host of new medical schools, but the federal government failed to expand funding for residency positions, citing caps imposed by the Balanced Budget Act of 1997. Legislation introduced to rectify this problem has only marginally increased the number of residency slots, and the ratio of applicants to positions, as well as the number of applicants failing to match, remains at record highs.
In addition to acting as a bottleneck for the production of greater numbers of physicians to offset the impending shortage, this shortfall of residency positions has had a number of additional downstream consequences. Neurology and the other cognitive specialties have seen record numbers of applicants. Although this increases our choices, it also has created the need for a laborious review process to sort through hundreds of applications and, in some instances, has necessitated automated screening rules which eliminate applicants based upon metrics such as USMLE scores, disadvantaging some otherwise excellent applicants. Furthermore, at a time when we are as a society are focusing on increasing diverse representation in all professions, diverse applicants from international medical schools find themselves at a greater disadvantage than ever; the NRMP reports that international medical graduates matched at a rate of 61% in 2020 (vs. 94% for graduates of U.S. medical schools). This has dramatically increased the number of chronically unmatched doctors in the United States, now estimated to approximate 10,000, at a time when many medical students carry educational debt of in excess of $200,000.
When we look back at academic neurology over the last 50 years, it becomes very apparent that our history would have been radically different and greatly diminished without the cadre of outstanding leaders, researchers, educators and clinicians who started their careers in international medical schools before bringing their considerable talents to the U.S. (truly some of the best and brightest from around the globe). These future superstars were attracted not only by the opportunities of the burgeoning American medical system, but also by the community of international medical scholars who took up residence here. The AAMC continues to lobby for legislative solutions to increasing the numbers of residency training positions, which we here at the AUPN also support. We will hope they meet with more success now that the importance of medicine to the nation is more apparent in the post-COVID era.
Clifton Gooch, MD
Today’s Resource Links
Renew your AUPN Membership for 2021
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AUPN Executive Council Elections
AUPN Department Chair Members who have not already taken the time to vote in this year’s Executive Council Elections please remember to cast your vote by Sunday, March 28th.
ANA 2021 Call for Abstracts
The ANA2021 Call for Abstracts is now open! To access the submission site click here. The deadline to have your work considered for presentation at this meeting is March 31st. All accepted works will be published in the Annals of Neurology.
AUPN’s Leadership Minute #6: Chair Evaluations of Faculty
Past AUPN Leadership Minutes
AUPN Winter Workshop Recordings
The Department Chair’s Directors Forum
The Program Director’s Workshop
The Clerkship Director’s Workshop
The Neuro Academic Recruiters Workshop
AUPN Fall Chairs Session Recordings
How to Get More Medical Students to Choose Neurology as a Career
How to Foster the Development of Junior Faculty
Managing Up and Down: Getting What You Need from Your Faculty and Your Dean