We have a physician shortage in every state. With 2.7 million Georgia residents in “Primary Care Health Professional Shortage Areas,” only 12 states have a worse primary care problem, according to data on the Kaiser Family Foundation website. Georgia’s overall physician-to-patient ratio is 23% worse than the national average. Georgia is projected to be short 8,012 doctors by 2030. The need for a more effective, efficient and fair admissions system has never been higher.
In all, 143 Georgia counties are designated health professional shortage areas, according to a 2024 report by the Cicero Institute. Further, rural and low-income communities are desperately in need of physicians, and 120 of Georgia’s 159 counties are rural. It is outrageous that our state government is ignoring this crisis. The same can be said for the federal government.
We have an abundance of highly qualified people who could apply to Georgia’s medical schools. But the system does not make it easy. One of the authors of this essay has had personal experience. He’s already spent $2,000 just preparing to apply to Georgia med schools and — because of the hoops an applicant is forced to jump through — will probably spend another $1,000 just trying to get into Georgia schools alone.
Credit: Contributed
Credit: Contributed
The organization controlling the gateway is the nonprofit Association of American Medical Colleges. It generated $354 million in revenue last year and netted $70 million in profit, according to investigative news site ProPublica. Its CEO earned $2.5 million. Not bad for a supposed nonprofit.
AAMC runs the medical school and residency program application system, administering the exams used to apply. It charges applicants exorbitantly at every step. Because of low acceptance rates, most applicants apply to over 20 schools to increase their acceptance odds. That alone costs the applicant over $1,000 before accounting for other costs, which range from $70-$150 per application. AAMC charges again when those students apply for residency slots.
Financial burden is only half the problem. The application process is staggeringly opaque. Medical schools publish vague expectations, send conflicting signals and offer little clarity regarding what makes an applicant competitive. This system rewards those who have doctors in the family, access to elite pre-med advising and insider knowledge passed down through networks most applicants will never access. AAMC even charges a subscription fee just to access the data applicants need to make informed decisions about where to apply. Ambiguity has a price, and those who can’t pay it are quietly filtered out.
Credit: Contributed
Credit: Contributed
Georgia has responded to its physician shortage by opening more medical school seats, including the recently opened University of Georgia School of Medicine located in Athens, a step in the right direction. But adding 64 students alone won’t solve the ongoing crisis. There are only 167 primary care residency slots in Georgia annually; a third of those residents eventually leave the state to practice elsewhere. Furthermore, the Georgia Senate reduced funding for primary care residency slots, eliminated one-time funding for resident education spaces and removed dedicated funding for rural surgery and child psychiatry residency slots. When we train doctors but don’t give them a reason — or a slot to stay — we are subsidizing the physician workforce of other states.
The solution to Georgia’s and our nation’s physician shortage requires action on multiple fronts. Georgia’s hospitals and medical schools must expand residency slots in parallel with new medical school seats, or the pipeline we’re building will drain straight out of state. State funding will be required. Nationally, the AAMC must be modernized and reformed to remove financial incentives, halting profiting from the desperation of medical school applicants and medical residents. It must standardize what it expects from applicants, so that navigating this process doesn’t require a network of insider connections. National legislation may be required to force these changes.
It is up to voters to ensure that our state and national politicians of both parties reach a bipartisan consensus to deal with the physician shortage issue. If not, the problem will only get worse.
Rawad K. Basma earned his bachelor’s and master’s degrees from UGA in nutritional sciences and wants to someday practice medicine here. Jack Bernard was the first Director of Health Planning for Georgia and is a nationally published authority regarding healthcare policy.
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