Two senior JAMA editors said federal probes of 26 medical schools’ admissions practices, along with new loan caps and visa limits, threaten efforts to ease the nation’s physician shortage.
Linda Brubaker, MD, deputy editor, and Gregory Curfman, MD, executive editor, made the case in a viewpoint published online Sept. 29.
The Justice and Education departments allege that admissions programs favor Black and Hispanic applicants over Asian and white applicants, violating Title VI of the Civil Rights Act of 1964. Schools under investigation include Yale University in New Haven, Conn.; Stanford (Calif.) University; Columbus-based Ohio State University; and Dartmouth College in Hanover, N.H. Title VI violations can cost schools their federal funding.
Dr. Brubaker and Dr. Curfman said the federal government “has abrogated its responsibility” to support an adequate physician workforce.
The Health Resources and Services Administration projects a shortage of more than 140,000 full-time equivalent physicians by 2038, with 30 of 35 specialties facing gaps. The number of Americans 65 and older is expected to rise from 58 million in 2022 to 82 million by 2050. One-third of adults already lack a usual source of primary care.
In 2024, non-U.S.-born international medical graduates practicing internal medicine cared for about 17.7 million Medicare beneficiaries, often in high-poverty and underserved areas. A Department of Homeland Security final rule now limits J-1 visas to four years. Trainees who need more time must apply for extensions, which may not be granted.
A federal loan cap for medical students of $50,000per year and $200,000 over a lifetime took effect July 1, and Grad PLUS loans were eliminated. The editors said high debt already steers graduates away from less lucrative specialties and locations.
Interest in medicine remains high: 54,699 people applied to medical schools in 2025, and enrollment topped 100,000. Yet only 5.3% of U.S. physicians were Black in 2024, compared with 14% of the population.
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