When the doctor shortage is personal

Cancer survivor Leonard Marquez, center, is pictured here with his wife, Jennifer, second from left, and his daughters, Abby, far left; Ellie, second from right; and Caroline, far right.

Credit: Leonard Marquez

In 2017, I was diagnosed with Stage 4 colon cancer. It was a devastating diagnosis, not only for me but for my wife and our three daughters. I was warned that only 6% of patients with my cancer diagnosis live more than five years. Yet today I am alive and cancer-free, thanks to a strong support system, good insurance, and proximity to top-tier academic health systems, where I received six years of state-of-the-art cancer treatments, including targeted chemotherapy, radiation, and, ultimately, surgery. I beat the odds: I was declared cancer-free in 2023.

What truly made the difference were the specialized physicians whose advanced training equipped them to diagnose and treat my rare, aggressive, and complex disease. Without them and the residency programs that prepared them, I simply wouldn't be here.

Graduate medical education (GME), the three to seven years of residency training doctors must complete after three to four years of medical school, is essential to ensuring our health care system can meet the needs of patients like me. And right now, the United States is not training enough physicians to keep up with demand.

Our population is growing - and getting older and sicker as well. By 2034, the number of Americans age 65 and older is expected to outnumber children under 18 for the first time in U.S. history. Older adults require more frequent and complex care, particularly from specialists such as oncologists, cardiologists, and geriatricians. Meanwhile, rates of chronic illnesses like diabetes, heart disease, and cancer continue to rise, driving demand for both primary and specialty care. Colorectal cancer, in particular, is the third most diagnosed cancer, and the third leading cause of cancer death, in both men and women. Add to all of this a growing general population, the lingering effects of the COVID-19 pandemic, and increasing burnout and retirement among practicing physicians, and it becomes clear: The pipeline of future doctors must grow significantly and urgently to meet patient needs.

According to the most recent AAMC physician workforce data, the United States faces a projected shortage of up to 86,000 physicians by 2036 - right around the time we expect to need them most. In practice, this shortage means longer wait times, delayed diagnoses, and fewer opportunities for early intervention - especially in rural and low-income areas. As a cancer survivor, I know firsthand that these are not simple inconveniences; they are often life-or-death necessities.

So, why is the United States failing to educate and train more physicians? After academic health systems and teaching hospitals, Medicare is the largest funder of GME, and a key obstacle is the outdated federal cap on Medicare-supported residency slots. This cap was imposed by Congress in 1997 and has remained largely unchanged, limiting hospitals' ability to expand and grow their residency training programs, even when they are willing and able to do so. This cap has created a bottleneck in the physician workforce pipeline, as all medical school graduates must complete residency to practice medicine in the United States.

There has been some bipartisan progress, though; in December 2020, Congress approved 1,200 new Medicare-supported GME positions - the first increase in 23 years. But that is just a start. Bipartisan legislation now in Congress, the Resident Physician Shortage Reduction Act of 2025 (S. 2439/H.R. 4731), would gradually add 14,000 more residency slots over the next seven years, helping to grow the physician workforce and expand access to care across the country.

Importantly, how these new positions are distributed will matter. We must ensure they reach communities where the need is greatest. In a divided political landscape, that means continued bipartisan cooperation and advocacy to prioritize health care access across the country. After all, a disease like cancer does not care whether you live in a red or blue state.

My own survival depended on physicians who had years of specialty training. Every one of them had to complete a rigorous residency program to practice medicine. Without that pathway, I wouldn't be here today, and others facing serious illness might not get the second chance I did.

We need to act now. Policymakers and the voters they're accountable to must show their support for legislation that expands the number of Medicare-funded residency slots. It won't solve the problem overnight, but it's one of the most direct and effective steps we can take to help ensure more Americans have access to the quality care they deserve - the kind that saved my life.