FP Report -- April 1999
Match trends show decline for second year
At press time, the National Resident Matching Program indicated that the 1999 fill rate for family practice residency programs was 2,697 positions filled out of the 3,265 positions offered. This is the second year the match program for family practice has experienced a decrease in positions filled.
In 1998, after six years of increases, the total fill rate was 85.5 percent, with 2,814 of the 3,293 available positions filled. The 1999 fill rate was 82.6 percent. The total number of family practice residency positions filled by U.S. seniors in 1999 trailed last year's match by 155. This year's numbers also showed a decrease in other categories of primary care in both total positions filled and those filled with U.S. seniors. The NRMP released the results March 20.
However, the trend is expected to be short-lived for a variety of reasons. "The number of third-year medical students who have joined the AAFP is significantly greater than the number of current fourth-year student members," said AAFP President Lanny Copeland, M.D., of Albany, Ga. "There is reason to believe that more of next year's fourth-year students will pursue family medicine."
Recently, medical students have received mixed messages about the stability of managed care and --with it -- primary care. "Students have been inundated with media reports predicting the end of managed care," said Copeland. "Stories are claiming that managed care is a fad and will fade, ending the need for primary care physicians. Research shows the opposite."
Students also are receiving the message from some professors that primary care soon will be handled by nurse practitioners and other midlevel providers. "Midlevel providers are unable to offer the same level of care as physicians; therefore, the implication is that the number of referrals to subspecialists will rise," he said. "Students are told that positions will be available in the subspecialties because that is where the patients will be. That's not necessarily so.
"Although the match numbers are somewhat down, there continues to be a need for well-trained, high-quality family physicians. Our members are constantly telling us how they are being overwhelmingly recruited for available jobs. Therefore, the AAFP will remain committed to ensuring that medical students receive as many opportunities as possible to fully understand what the practice of family medicine truly represents."
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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