Invitation to a Dialogue - A Doctor Shortage - NYTimes.com With the expansion of coverage under the Affordable Care Act set to take effect next year, the United States is facing an alarming physician shortage. We don't have enough physicians to treat insured patients right now. What happens when there are an estimated 30 million more insured patients in 2014? The American Association of Medical Colleges estimates that by 2015, the shortage of doctors across all specialties will quadruple, to more than 60,000. By 2025, that number will reach a staggering 130,000. Last year there were 45,266 medical school applicants competing for 19,517 seats. Thousands of qualified people every year can't get into medical school. This will be partly addressed by plans to open new medical schools and expand existing ones. But there's a bigger problem. After graduating from medical school, a newly minted doctor must complete a three-to-seven-year residency before practicing independently. These residency positions are largely federally funded, and while medical school enrollment has been slowly increasing, the number of residencies has been capped since the 1997 Balanced Budget Act. A bill recently introduced in Congress would increase the number of residency training programs by 15,000 over five years. And while I applaud this proposal, it's estimated that it will supply not even half of the physicians necessary to address our shortage. We need to do more. Here's one idea: Foreign-trained physicians usually must complete a residency here before they are licensed to practice independently. We ought to allow them to quickly prove their competence, sit for the boards and start taking care of patients. I am pleased that 30 million Americans will soon have health insurance for the first time. But health insurance is pretty useless if you can't find a doctor to treat you and your family. The writer is about to begin medical school at the University of Miami. We plan to publish responses and Mr. Busko's rejoinder in the Sunday Review.