FEATURE: PERSPECTIVE A Shortage of Medical Residency Positions: Parallels with Psychology Donna LaPaglia & William N. Robiner & John A. Yozwiak & Cheryl Brosig & Barbara Cubic & Gerald Leventhal Received: 10 November 2014 /Accepted: 5 March 2015 # Academic Psychiatry 2015 Abstract Physician shortages in the US are expected to in- tensify with the implementation of the Patient Protection and Affordable Care Act. These shortages may negatively impact access to care, quality of care, and confidence in the system’ s ability to adequately provide for health needs in the US. Con- cerns regarding physician demand underscore how critical Graduate Medical Education funding is to preparing the physician workforce. In 2014 5.6 % of US medical school seniors did not match into residency. Psychology has faced longstanding training imbalance issues with a misalignment between the number of internship positions and the number of applicants. The authors summon attention to the damaging effects a training imbalance poses to a health care profession, its trainees, and ultimately the public it serves. Keywords Residency imbalance . Internship imbalance . Match . Workforce . Resident . Psychiatry . Psychology The US is facing a physician shortage that will likely adversely impact public health [1]. The anticipated influx of consumers to the health care system following the 2010 signing of the Patient Protection and Affordable Care Act (PPACA) [2] into law compounded concerns about physician shortages associated with an aging and expanding population with more chronic disease [3]. The Association of American Medical Colleges (AAMC) Annual Review in 2012 speculated that there may be neither enough human resources nor proper care models to manage the high numbers of new consumers [4]. The report also projected that there will be a shortage of 159,300 physician FTEs by 2025. The physician shortage is significant both in primary care and specialist medicine. Resident subspecialization may exacerbate the deficit in primary care as physicians narrow the focus of the problems they treat [3]. It is estimated that by 2020, the USA may face shortages of 45,400 primary care phy- sicians and 46,100 physicians in surgery and specialties [5]. The National Center for Health Workforce Analysis identifies psy- chiatry as one of three specialties in which per capita declines are anticipated by 2025 [6]. Projections on the future physician workforce have limited precision. Nevertheless, academic institutions have responded to the threat of shortages by increasing allopathic medical school class size and by opening a number of new medical schools [7]. As a result, medical school enrollments have in- creased by 16.6 % [7, 8] over the past decade and may well increase to 29.6 % by 2017 [7]. For this expansion to effec- tively satisfy demand, it must address specific workforce needs, e.g., increase the number of physicians practicing in primary care settings and rural practice settings [8]. Addition- ally, the number of osteopathic medical schools has increased Material was presented as a poster Expanding the Supply of Residency Training Slots for Medical School Graduates: Lessons Learned from the Supply–Demand Imbalance of Psychology Training Internship Slots, at the 2013 AAMC Physician Workforce Research Conference in Alexandria, VA. D. LaPaglia (*) Yale School of Medicine, New Haven, CT, USA e-mail: donna.lapaglia@yale.edu W. N. Robiner University of Minnesota Medical School, Minneapolis, MN, USA J. A. Yozwiak University of Kentucky College of Medicine, Lexington, KY, USA C. Brosig Medical College of Wisconsin, Milwaukee, WI, USA B. Cubic Eastern Virginia Medical School, Norfolk, VA, USA G. Leventhal New Jersey Medical School, Newark, NJ, USA Acad Psychiatry DOI 10.1007/s40596-015-0324-y