New licensures hit all-time high
Texas continues to draw new physicians, this year more than ever. The Texas Medical Board reported 3,630 newly li- censed physicians — an all-time high — in fiscal year 2012, which ended Aug. 31. That number represents a 5.6-percent increase over the 3,436 new physician licensures recorded in 2011. The board also received a record 4,253 medical li- cense applications. This year also brought the second highest number of newly licensed phy- sicians from beyond its borders, top- ping 2008 by a mere 1 percent. Most of those physicians — roughly three out of four, or 73.5 percent -—graduated from medical schools outside of Texas. Over- all, 42.1 percent, or 1,528, came from other states or Canada, a slight uptick from 2011.
That’s compared with 26.5 percent of new doctors, or 963, who hailed from Texas schools in 2012, on par with the 966 in-state licensures in 2011. Meanwhile, international medical
graduate (IMG) licensures peaked at 1,139, up from 1,017 in 2011 and the last record of 1,032 set in 2008. Texas Medical Association staff attributes the spike, at least in part, to the passage last legislative session of Senate Bill 189, a new law that as of Sept. 1 required cer- tain noncitizen physicians to practice three years in an underserved commu- nity as a condition of full licensure in Texas. (See “Good Intentions,” pages 53–55.) Some observers say the new service obligation could have a chilling effect on IMGs interested in practicing in Texas in the future, and the additional requirement may have motivated more IMGs to apply for licensure in advance of its implementation.
Overall, the number of physician li-
censures has steadily climbed since TMA secured the 2003 passage of Proposition 12, the voter-approved constitutional tort reform amendment that authorized the Texas Legislature to cap noneco-
56 TEXAS MEDICINE December 2012
nomic damages in medical liability cases. Since then, Texas has licensed more than 28,000 new physicians, adding an aver- age of 3,135 newly licensed each year — a 33-percent jump over the annual aver- age of 2,363 licensees in the nine years preceding Proposition 12.
dency slots also would be dedicated to training in specialties in which there is a physician shortage, as designated by the federal government.
“This shortage will only continue to
grow if we don’t begin to address the problem now,” Representative Schock said in a statement. Hospitals may receive new residency slots based on certain criteria, including whether the institutions:
GME bill would create more medical residency slots
Legislation introduced in Congress in August would create 15,000 new Medi- care-funded graduate medical educa- tion (GME) slots for physician residen- cy training — 3,000 per year over five years — in an effort to ease the nation’s physician shortage. The Association of American Medi-
cal Colleges, which supports the bill, es- timates that by 2015, the country will have 62,000 fewer doctors than needed. Texas ranks 42nd out of 50 states and the District of Columbia in physician-to- population ratio for patient care, even though the state continues to license re- cord numbers of new physicians. The Texas Medical Association sup-
ports such efforts to increase GME slots, which it says are critical to training a suf- ficient number of physicians to care for Texas’ rapidly growing population. TMA research shows physicians who complete both medical school and GME in Texas are three times more likely to stay in the state to practice.
Under the federal Resident Physi- cian Shortage Reduction and Graduate Medical Education Accountability and Transparency Act (HR 6352), sponsored by Reps. Aaron Schock (R-Ill.) and Ally- son Schwartz (D-Pa.), qualifying teach- ing hospitals could receive up to 75 slots between calendar years 2013 and 2017. Representative Schock said the limit would help ensure that small and rural hospitals are able to compete for the slots along with large hospitals and hos- pital systems. A number of the new resi-
• Are located in states with new medi- cal schools or new branch campuses;
• Emphasize training in community health center or community-based settings, or in hospital outpatient departments;
• Qualify for electronic health record incentive payments; and
• Exceed the current federal cap on the number of residents trained.
The bill also would require teaching hospitals to report on their program costs, as well as certain quality measures established by the U.S. Department of Health and Human Services in conjunc- tion with accrediting bodies. Failing to report on the quality measures could re- sult in a cut to hospitals’ indirect medical education funding. Among other things, teaching hospi-
tals would have to demonstrate the ex- tent of training they provide in:
• Evaluation and management, • Coordination of patient care, • Relevant cost and value of various di- agnostic and treatment options,
• Methods for identifying system errors, and
• Use of health information technology. The American Association of Colleges
of Osteopathic Medicine also backs the legislation. n
Amy Lynn Sorrel is an associate editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
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