On March 29, Reps. Terri Sewell (D-AL) and Brian Fitzpatrick (R-PA) introduced the bipartisan Resident Physician Shortage Reduction Act of 2023. This legislation would combat the nation’s physician shortage and improve access to health care by expanding the number of Medicare-supported medical residency positions by 14,000 over seven years. The CAP has long advocated for increased funding to support more GME residency slots, which is essential to addressing critical shortages of pathologists in the coming years and is one of the 2023 Advocacy asks.

Medicare pays for direct GME, the costs of educating residents, and indirect medical education to cover the generally higher costs teaching hospitals to incur. Congress made a critical initial investment in the physician workforce by providing 1,000 new Medicare-supported GME positions in the Consolidated Appropriations Act of 2021, the first increase of its kind in nearly twenty-five years.

The United States is facing a shortage of up to 124,000 physicians, according to a recent study from the Association of American Medical Colleges (AAMC). This is exacerbated by an aging physician population, rising rates of physician burnout, and early retirement due to the COVID-19 pandemic.

The demand for trained pathologists exceeds the supply provided by the number of existing residency positions. For example, the CAP’s 2021 Practice Leader Survey data suggests a nationwide demand of 1,000-1,200 pathologists to fill open positions in the United States in recent years. However, these numbers are substantially lower than the demand reported for 2022.

In contrast, over the last decade or so, approximately 620 pathologist residency positions have been available each year. However, of those pathologists that complete residency, not all go on to practice full-time due to various reasons, including some opting to pursue research or go into the industry rather than clinical practice and others being international medical graduates (IMGs) that rely on J-1 visas. In 2022, 33.3% of first-year pathology resident slots were non-US IMGs.