Family medicine residency training programs attracted 1,335 medical students in the 2012 National Residency Matching Program, continuing a trend in medical students’ growing interest in becoming family physicians.
Medical student interest in family medicine lagged in the early 2000s due to several factors. Among them: plummeting support for family medicine residency training, the resulting loss of training positions and a growing income gap between primary care and subspecialist physicians. AAFP has proposed a solution that would improve primary care physician training and build the primary care physician workforce.
The most important purpose of medical schools is to educate a physician workforce that meets the nation’s needs. Meeting this “social mission” requires an adequate number of primary care physicians, distribution of physicians to underserved areas and diversity in the physician workforce. However, medical schools vary significantly in meeting these goals and school rankings based on the social mission score differ from those that use research funding and subjective assessments of school reputation. These findings suggest that initiatives at the medical school level could increase the proportion of physicians who practice primary care, work in underserved areas, and are underrepresented minorities.
The current system encourages academic health centers to distribute Graduate Medical Education funding to lucrative subspecialty training, where residents learn procedures that generate more income for sponsoring hospitals than their primary care counterparts.
With a cap on the total number of residency positions they can sponsor, teaching hospitals have reduced the number of family medicine residency positions while they have increased the number of subspecialty residency positions. Equally concerning, as teaching hospital turn to lucrative subspecialty training, the number of primary care training programs has fallen dramatically.
Education economists and analysts recommend allocating graduate medical education funds directly to primary care residency programs, increasing support for Health Professions Training Grants, and closing the income gap between primary care physicians and subspecialists. Together, these efforts will do much to increase medical student interest in careers in primary care.
Successfully building the primary care physician workforce depends on adequate support for primary care medical education and workforce initiatives. The American Academy of Family Physicians has called on Congress to adequately fund programs that invest in educating and training primary care physicians.
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Turning the ship on shortage of family physicians —improving medical education, filling the family physician pipeline