The landscape of medical education and residency training is evolving rapidly, driven by economic pressures, workforce shortages and changing educational priorities.
Here are 10 key trends and updates shaping the future of medical education and training.
1. Residency slots are at risk.
The longstanding federal cap on Medicare-supported residency slots, combined with mounting financial pressures on hospitals, is threatening the nation's ability to train new physicians. Many large academic medical centers fund training costs beyond what Medicare reimburses, covering the full cost for approximately 25,000 residents at an average of $184,000 per resident annually, as of 2021. However, as hospitals face ongoing rising labor and supply costs, experts warn that self-funded residency positions may not be sustainable long term.
"It is extremely expensive," said Leonard Marquez, senior director of government relations at the Association of American Medical Colleges. "Those over-the-cap positions are the types of things I think are at risk [of being cut amid escalating costs.]"
Dermatology remains one of the most competitive specialties, drawing applicants due to its high earning potential and favorable work-life balance. The field has seen a 50% increase in medical residency applications over the past five years, with women making up 71% of applicants who list dermatology as their first choice. Some programs report receiving 600 applications for just four available spots.
3. Hospital groups weigh residency slot expansion bill.
A draft Senate bill proposes adding 5,000 new Medicare-supported residency slots, but hospital groups are divided on the measure. While the American Hospital Association supports the initiative, it warns that changes to funding formulas could strain certain teaching hospitals. The AAMC has called for an expansion to 10,000 slots to help address a projected shortage of 180,000 physicians by 2037, according to data from the Health Services and Resources Administration.
4. Revised oaths spark debate in medical schools.
Medical schools are modernizing the Hippocratic Oath to reflect contemporary ethical challenges, sparking debate among educators and physicians. At Harvard Medical School, for example, each incoming class writes its own version of the oath, while other institutions incorporate student input into revisions. These updates often address topics such as health equity, diversity and patient advocacy while maintaining core ethical principles. Critics argue that modifying the oath disrupts a longstanding tradition, while supporters believe the changes encourage deeper ethical reflection among students.
5. New medical school rotations offer unique decisions.
Beyond traditional rotations in internal medicine and pediatrics, some medical students are engaging in "away rotations" that provide unconventional training experiences. These rotations, required for all DO candidates, may include ambulance rides, forensic pathology in autopsy suites, prison healthcare, culinary medicine and even aerospace medicine at NASA. The AAMC reports that over 15,000 away rotations are available, including trauma and rescue simulations for events like airplane crashes and water rescues.
6. Geriatric medicine slots go unfilled.
Despite the increasing need for geriatric specialists, the field continues to struggle with poor residency fill rates. In the 2025 match year, only 169 of 382 available geriatric medicine slots were filled. This continues a downward trend, with fill rates dropping from 52% in 2021 to just 44.2% in 2025. The shortage is particularly concerning, given that the U.S. population ages 65 and older is expected to grow from 58 million in 2022 to 82 million by 2050.
7. Medical schools embrace reforms to close education gaps.
As demand for new physicians rises, medical schools face criticism for outdated curricula that fail to prepare students for modern healthcare challenges. Calls for reform focus on incorporating clinical care processes, evidence-based practice frameworks, emerging technologies and proactive healthcare strategies into medical education.
8. Disability education falls short.
A Northwestern Medicine study found that medical schools inadequately prepare students to care for patients with disabilities. The study highlighted how curricula often portray disabilities as problems within the patient rather than addressing systemic barriers to care. This lack of training can reinforce ableism and contribute to suboptimal healthcare experiences for individuals with disabilities.
"Ultimately, our work reveals how medical education may be playing a critical role in creating and perpetuating ideas that people with disabilities are uncommon and unworthy in healthcare," study author Carol Haywood, PhD, assistant professor of medical social sciences at Northwestern University Feinberg School of Medicine, said in the news release.
9. Medical schools see record-high enrollment as applications fall.
Although the number of medical school applications declined for the third consecutive year in the 2024 to 2025 academic cycle, enrollment reached a record high. Applications dropped 1.2% to their lowest level since the 2017 to 2018 cycle, but total enrollment increased by 1.8% to 99,562 students.
10. Three-year medical school on the rise.
In 2015, around eight medical schools were offering three-year medical programs. Today, that number has risen to more than 30. Accelerated medical programs are part of a movement to get more students interested in being physicians and closing the workforce gap sooner.
Some critics have worried that accelerated programs would harm education quality or student preparation, but those fears appear to be unfounded.