Graduate medical education and physician supply in New York state

Objectives.-To estimate the supply of physicians and residents in New York State and to assess the impact of state policies on the supply and distribution of physicians in the state. Design.-A comparison of the number of residents in New York State for 1988 and 1994 (from the American Medical Association Medical Education Database) and the number of active patient care physicians in New York by specialty and age (from the 1995 New York State Physician File). Main Outcome Measures.-Changes in the number of residents in New York State between 1988 and 1994 by specialty and medical school location-estimates of the numbers of physicians by age and specialty in New York for 1995; the migration of new physicians into and out of the state. Results.-The number of residents in New York State grew by nearly 21% between 1988 and 1994, despite a number of policies and programs encouraging maintenance of production levels. This growth is attributed to increases in the number of international medical graduates (IMGs) entering residency training through a widening ''IMG window.'' Projection models show that, if production of new physicians continues at current levels, the supply of physicians will grow substantially during the next 2 decades. Conclusions.-Past policies to influence the supply, production, and distribution of physicians in New York State have not had their desired effects. Future policies and incentives must be carefully framed and coordinated to avoid similar failures.