April 2002 • Volume 8 • Number 4 |
Match results mixed across primary
care
Overall family practice fill rate up
from last year
The gap between the number of family practice residency positions offered and those filled closed slightly this year, according to preliminary results released March 21 by the National Resident Matching Program. Of 2,983 residency slots available, 2,357 were filled, for an overall fill rate of 79 percent compared with 76.3 percent last year.
That's a hopeful sign, says AAFP President Warren Jones, M.D., of Ridgeland, Miss., but this is no time for the specialty to relax its advocacy efforts. "We must continue to educate medical students, legislators, our patients and the public about the critical role family physicians play in the nation's health care," he says.
Studies by the Robert Graham Center in Washington have shown that Americans rely on family physicians for their care more than on any other specialists.
"Increasing the number of subspecialty physicians at the expense of primary care limits our capacity to meet the needs of vulnerable populations, including the uninsured, underinsured, and underserved urban and rural patients," says Jones.
 *Source: National Resident Match Program |
U.S. SENIORS STILL HESITANT
Granted, the percentage of family practice positions filled with U.S. seniors declined slightly from 2001 to 2002 -- from 49 percent to 47.4 percent -- but that's not nearly the 8.2 percent dip seen between 2000 and 2001. The total percentage of U.S. seniors choosing family practice also showed a modest decline, with 10.5 percent matching in family practice compared with 11.2 percent last year.
Even so, it can't be ignored that this year, 2,357 individuals selected family practice as their specialty of choice -- only six fewer than last year. These data appear to herald a leveling off of the downward trend seen in the family practice fill rate since its record high 90.5 percent in 1996, says Perry Pugno, M.D., M.P.H., director of the AAFP Division of Medical Education.
The results seem to confirm the wisdom of the specialty's recent shift in priorities -- focusing less on increasing the number of people choosing family practice and more on continuing to ensure the quality of those entering the specialty, he says.
"In addition to selecting intellectually qualified medical school applicants who possess the personal characteristics that predispose them to caring for medically underserved populations, it's essential that we ensure an ongoing high level of professionalism in medical schools," Pugno says.
OTHER PROGRAMS VARY
Among other primary care programs, overall fill rates varied this year. Pediatrics-primary and internal medicine-pediatrics saw lower fill rates in 2002 than in 2001. The internal medicine-primary fill rate, however, increased this year.
As for U.S. seniors filling residencies in these programs -- again the results were mixed. For pediatrics-primary and internal medicine-primary, the 2002 fill rate by seniors went up. For internal medicine-pediatrics, the proportion dropped this year.
Visit http://www.aafp.org/match/ for the full slate of this year's NRMP results.
The results continue to illustrate some students' hesitancy to enter primary care in the face of mounting medical school debt and declining reimbursement levels. Lifestyle issues have also been shown to play a role in specialty choice, as has the perception of primary care as a less prestigious area of medicine.
AAFP ADDRESSES CONCERNS
The AAFP is addressing these issues, says Jones. The Academy continues to lobby vigorously on behalf of Title VII funding for family practice training. And it keeps bending lawmakers' ears to correct the flawed Medicare conversion factor formula that results in insufficient physician reimbursement.
A University of Arizona study is expected to shed light on medical students' choice of specialty and offer tools to better engage their interest. In addition, the Future of Family Medicine project, a collaboration between the AAFP and six other organizations, promises to provide insight into the strategic direction the discipline should take, says Jones.
"This collaboration is intended to evaluate the health care needs and expectations of our patients, improve the delivery of care, and enhance training and lifelong learning for family physicians," Jones says.
FP Report is published by the
AAFP News Department.
Copyright © 2002 by
American Academy of Family Physicians.