Health

HEALTH • Fall 2018 15 concerned about incoming stu- dents' ability to find residency training when they graduated, and 80 percent were worried about resi- dency opportunities nationwide. The orthopedics department at UMass Medical School has been able to grow in part because it has found residency opportunities, Ayers said. "We matched seven into orthope- dic surgery, which is the highest we've had," Ayers said. Ayers attributes a rise in interest in orthopedics to a growing need for orthopedic services and the clear way in which people can see the lifestyle change that orthope- dic services can offer. As orthope- dic operations have become more common, they've also evolved into outpatient procedures that can make them cheaper and more appealing.Older adults these days have more of a desire to maintain an active lifestyle, he said, and are expected to increasingly turn to hip and knee replacements to help them do it. across the country have seen. Nationally, medical school enroll- ment is up 28 percent since 2002, the Association of American Medical Colleges reported last year. In that span, 22 new medical schools have been established and accredit- ed, accounting for nearly 40 percent of the enrollment growth. High demand meets high need It isn't simply that more students want to go into medicine. There's more of a need, which is projected only to grow in the coming decades. The Association of American Medical Colleges has forecasted a shortage of as many as 105,000 phy- sicians by 2030, largely because of an aging population. Not only are more doctors retiring, but an older popu- lation requires more care. The num- ber of Americans over 65 is expected to increase by 50 percent by 2030. "We may still have a physician deficit," Flotte said, "but we're trying to do our part to help try to fill the physician workforce." The association's report also showed that UMass Medical School isn't alone in struggling to find enough residency positions for its students. A survey of medical school deans found that 39 percent were H UMass Medical School's doctoral program has grown by 30 percent in the past decade. PhD spike Source: UMass Medical School 0 100 200 300 400 500 600 UMass Medical School enrollment MD MD/PhD 408 27 499 66 Fall 2007 '08 '09 '11 '12 '13 '14 '15 '16 '17 '18 percent in the past decade, exceeding what has been a much broader rise in medical school students nationally. Medical schools aren't able to increase enrollment as easily as undergraduate programs are, with residency opportunities and other factors to consider. School leaders want to make sure faculty can keep up with growth and that clinical affil- iations provide enough opportunities for students, Flotte said. New opportunities for growth Still, UMass has found ways to grow in recent years. In 2013, the school opened the $400-million Sherman Center, which allowed it to finally expand capacity after being constrained for space for years. In 2016, it opened seats to out- of-state students for the first time and began an affiliation with Cape Cod Health to give roughly 15 stu- dents clinical rotations there. Last fall, it opened a campus in Springfield, its first outside Worcester, with a class of 25 students and a plan to expand to roughly 100. "Based on our first class, we're off to a good start," said Andrew Artenstein, the regional executive dean for UMass Medical School- Baystate, as the Springfield campus is known. "These are people who I can see as future medical leaders." Many of the medical students in Springfield are first in their families to go to college, Artenstein said, and many are minorities who are under- represented in health care. The Springfield site also offers another new component of the med- ical school: a focus of study on needs of patients in underserved urban and rural areas. Each student on the campus is in that track of study, whether or not they end up in that specialty. The idea, Artenstein said, is to give students a broader look at the health needs of an area beyond just medicine, to include how their wellbeing is affected by their jobs, their home life, nutrition and transportation opportunities, such as getting to where they can see a doctor or buy healthy groceries. Back in Worcester, the medical school is seeing the sharpest rises in enrollment in areas like emergency medicine, general internists and hospitalists, who oversee a broad range of care similar to generalists. Radiology and orthopedics have also seen more interest from students. Enrollment growth has been in line with what medical schools "The orthopedics department at UMass has been able to grow in part because it has found residency opportunities. We matched seven into orthopedic surgery, which is the highest we've had." Dr. David Ayers, Chair of the Department of Orthepedics at UMass Medical School P H O T O / C O U R T E S Y

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