Improve Public Medical School, FM Department Support

Want to improve Americans' health? Boost support of publicly funded medical schools and work to ensure that all schools have family medicine departments.

That's the message for health care policy makers in "Entry of U.S. Medical School Graduates Into Family Medicine Residencies: 2006-2007 and 3-Year Summary," (12-page PDF; About PDFs) an analysis in the September issue of Family Medicine of National Resident Matching Program data.

Improved funding for public medical schools and more support for family medicine departments are likely to increase the number of medical school graduates who become family physicians, according to article author Perry Pugno, M.D., M.P.H., director of the AAFP Division of Education, and his colleagues.

In the article, Pugno and his coauthors review data describing medical students who entered family medicine residencies in 2006. They also point to the plethora of research showing the direct link between access to primary care and improved quality of care, health outcomes and the population's overall health. That link reinforces the Academy's position on workforce reform that America's medical schools must generate at least 30 percent more family physicians as they aim to increase medical school enrollment, say Pugno and his coauthors.

Data from the 2006 Match show that more U.S. graduates from public university medical schools -- particularly those with departments of family medicine -- choose the specialty than do students from private schools without family medicine departments.

More than 10 percent of graduates from 77 publicly funded medical schools chose family medicine as their specialty, compared with 6 percent from 48 privately funded medical schools, according to Pugno and his colleagues. Public and private medical schools that have departments of family medicine matched 9.1 percent of their graduates in the specialty, almost eight times more than the 1.2 percent who graduated from schools without departments of family medicine.

"The association between departmental status and increased percentage of graduates matching in family medicine continued in 2007," the authors write.

Family medicine's pipeline is vital to halting the deterioration of a national health care system characterized by a growing infant mortality rate, falling lifespan, spiraling costs and plummeting quality. Filling that pipeline depends on the nation's schools producing more primary care physicians, say health care analysts.

"In an effort to avert a predicted physician shortage, the AAMC (Association of American Medical Colleges) workforce report calls for a 30 percent increase in allopathic matriculation," write Pugno and his coauthors. "Workforce policy adopted by the AAFP states that simply increasing the number of medical school graduates will result in a physician workforce that will continue to be inappropriately distributed to care for the needs of the nation."

The authors conclude that "The United States needs, and its population deserves, a primary care physician-based health care delivery system. With the predicted decline in the production of generalists in internal medicine and in pediatrics, it will be critical for the nation's health that increased numbers of family physicians be trained in the United States."