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Despite the careful stewardship of the Academy and other family medicine organizations, preliminary results released March 20 by the National Resident Matching Program show that family practice continues to struggle to position itself as the specialty of choice among medical students.
The early data showed that of 2,940 family practice residency openings offered, 2,239 were filled, yielding an overall fill rate of 76.2 percent compared with last year's rate of 79 percent.
Yet it's the proportion of U.S. seniors selecting family practice that's most concerning. Of the 2,940 openings, only 1,234 were filled with U.S. grads -- a rate of 42 percent compared with last year's 47.4 percent.
Not welcome news, certainly, but not unexpected, either, for those who have tracked the specialty's progress through a quagmire of declining reimbursement, increasing regulatory burdens and flagging federal support of family medicine training programs.
"We realize those factors -- and others -- are going to influence medical students thinking about entering family practice," said AAFP President James Martin, M.D., of San Antonio. "That's why we initiated the Future of Family Medicine project, commissioned the University of Arizona study of student specialty choice, and continue to lobby on behalf of family physicians and their patients."
Since last year's match, Academy leaders and other FPs have made more than two dozen Capitol Hill visits, advocating the specialty's interests and seeking legislative support on key issues. AAFP officers have met with White House officials, and FP visits to statehouses across the country have numbered in the hundreds.
The FFM project (see front-page story) was created to ascertain patients' future health care and technology needs and to ensure the discipline stands ready and able to fulfill those needs. FFM initiatives include developing an open-source electronic health record to enhance quality, safety and efficiency; working with family medicine educators to provide a future-oriented residency curriculum; and continuing to offer cutting-edge, evidence-based CME.
The AAFP Board of Directors last month approved recommendations that address specific issues identified in the student interest study by the University of Arizona, Tucson. For more on the recommendations, developed jointly by the AAFP Commission on Education and Commission on Resident and Student Issues, go to http://www.aafp.org/fpr/20030400/2x.html.
"With the health care needs of millions of Americans at stake, our medical schools must provide a positive training environment for future FPs," Martin said. "The federal government must support family practice funding and initiatives.
"Family physicians are fundamental to a successful U.S. health care system. Current and future FPs must have the tools and training they need to serve their rural, urban and underserved patient populations. The AAFP is working to ensure our country doesn't lose its family doctors. I challenge patients, the federal government, medical schools and physician role models to do the same."
To reach writer Cindy McCanse, e-mail cmccanse@aafp.org.
FP Report is published by the
AAFP News Department.
Copyright © 2003 by
American Academy of Family Physicians.