Graham Center One-Pager

Who Filled First-Year Family Medicine Residency Positions from 1991 to 2004?



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Am Fam Physician. 2005 Aug 1;72(3):392.

Graduates of U.S. allopathic schools have filled less than one half of the family medicine positions offered in the National Resident Matching Program (NRMP) Match since 2001. Overall fill rates in July have been relatively stable at approximately 94 percent. Family medicine has become reliant on international medical graduates (IMGs), who in 2004 made up 38 percent of first-year residents.

During the early 1990s, family medicine training positions increased by more than one third, adding about 900 positions, and the specialty enjoyed a revival of medical student interest.1  Allopathic graduates’ interest in family medicine has fallen precipitously since its height in 1996, when allopathic graduates filled almost three out of four training positions. Despite a poor fill rate in the NRMP Match each March (Table 1),2  by the start of the internship year in July, around 94 to 97 percent of positions are filled (Table 2).3

TABLE 1

Family Medicine Positions Filled in the March NRMP Match

1998 1999 2000 2001 2002 2003 2004

Positions available

3,293

3,244

3,183

3,074

2,962

2,920

2,864

Percentage filled by U.S. seniors

66

62

57

49

47

42

41

Percentage filled by IMGs

10

13

15

16

20

24

26

Percentage filled

85

83

82

76

79

76

79


NRMP = National Resident Matching Program; IMG = international medical graduate. Information from reference2.

TABLE 1   Family Medicine Positions Filled in the March NRMP Match

View Table

TABLE 1

Family Medicine Positions Filled in the March NRMP Match

1998 1999 2000 2001 2002 2003 2004

Positions available

3,293

3,244

3,183

3,074

2,962

2,920

2,864

Percentage filled by U.S. seniors

66

62

57

49

47

42

41

Percentage filled by IMGs

10

13

15

16

20

24

26

Percentage filled

85

83

82

76

79

76

79


NRMP = National Resident Matching Program; IMG = international medical graduate. Information from reference2.

TABLE 2

First-Year Family Medicine Positions Filled by July

1998 1999 2000 2001 2002 2003 2004

Positions available

3,723

3,644

3,623

3,528

3,523

3,480

3,501

Percentage filled by IMGs

15

15

19

30

32

38

38

Percentage filled

96

97

96

96

95

96

94


IMG = international medical graduate.

Information from the American Academy of Family Physicians and reference 3.

TABLE 2   First-Year Family Medicine Positions Filled by July

View Table

TABLE 2

First-Year Family Medicine Positions Filled by July

1998 1999 2000 2001 2002 2003 2004

Positions available

3,723

3,644

3,623

3,528

3,523

3,480

3,501

Percentage filled by IMGs

15

15

19

30

32

38

38

Percentage filled

96

97

96

96

95

96

94


IMG = international medical graduate.

Information from the American Academy of Family Physicians and reference 3.

The absolute number of allopathic students currently choosing family medicine has declined only slightly compared with the period before the 1990s; but in the context of the larger number of medical residency positions available, the decline has been steep. The combination of a substantial increase in family medicine training positions and a drop in U.S. medical graduates’ interest has yielded an almost threefold rise in the number of IMGs who fill first-year family medicine positions. In 2004, IMGs composed 38 percent of first-year family medicine residents, up from 15 percent in 1998. Currently, IMGs make up about 16 percent of the family medicine physician workforce. It remains to be seen how this internationalization of family medicine will affect the specialty in the United States, and medicine as a whole worldwide.

REFERENCES

1. Green LA, Dodoo MS, Ruddy G, et al. The physician workforce of the United States: a family medicine perspective. Washington, D.C.: Robert Graham Center, 2004.

2. NRMP results and data 2004 match. Washington, D.C.: Association of American Medical Colleges, 2004. Accessed online May 24, 2005, at:http://www.nrmp.org/res_match/data_tables.html.

3. Pugno PA, McPherson DS, Schmittling GT, et al. Results of the 2004 National Resident Matching Program: family medicine. Fam Med. 2004;36:562-70.

note: The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP.

Adapted from the Graham Center One-Pager #33. Klein LS, Ruddy GR, Phillips RL, McCann JL, Dodoo MS, Green LA. Who filled first-year family medicine residency positions 1991–2004? August 2005. Available online at: http://www.graham-center.org/onepager33.xml. From the Robert Graham Center: Policy Studies in Family Medicine and Primary Care, 1350 Connecticut Ave., NW, Suite 201, Washington, DC 20036 (telephone: 202-331-3360; fax: 202-331-3374; e-mail: policy@aafp.org).

 


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