2011 Match Results Again Spotlight Family Medicine Gains

For the second year in a row, the number of medical students choosing to enter family medicine has risen. That's according to the results of the 2011 National Resident Matching Program, or NRMP. Known as the Match, preliminary figures from this year's NRMP show that family medicine residency programs filled 2,576 positions of the 2,730 offered, for a record-high fill rate of 94.4 percent.

That fill rate is 3 percent higher than last year's figure and comes at a time when family medicine residency programs offered an additional 100 positions in this year's Match. Included in this category are family medicine-psychiatry, family medicine-emergency medicine, family medicine-preventive medicine and family medicine-internal medicine programs.

Moreover, of those 2,576 candidates who selected family medicine, 1,317 of them are U.S. medical school graduates -- an increase of 133 compared with 2010.

The demographics of the applicant pool also have changed, with more U.S. seniors and D.O. candidates applying through the Match in 2011. Overall, the percentage of U.S. seniors who chose family medicine rose from 7.9 percent in 2010 to 8.4 percent this year.

AAFP President Roland Goertz, M.D., M.B.A., of Waco, Texas, welcomed the news, saying in a prepared statement that the increases suggest an upswing in interest in the specialty among U.S. medical school graduates.

"This year's results mark the second consecutive year of increased interest in family medicine," Goertz said. "Although several factors likely contribute to the increase, we believe an important element is recognition that primary care medicine is absolutely essential if we are to improve the quality of health care and help control its costs.

"Of course, sustaining this interest will require continuing changes in the way America pays for and delivers health care to patients," he added.

In addition to family medicine, two other primary care specialties saw increases in the number of U.S. seniors filling their residency positions. Twenty-six more residency positions were filled in internal medicine-primary compared with 2010, with 10 more positions than last year going to U.S. seniors. Seven more positions were filled in internal medicine-pediatrics compared with 2010, and 10 more U.S. seniors chose the specialty than did last year.

"Primary care has become much more visible as a result of the discussion about improving our health care system," said Goertz. "More people understand that if we're to have high quality care at a controllable cost, we need to balance our system on a foundation of primary medical care."

According to an AAFP Division of Medical Education summary of the 2011 Match results, the increased percentage of medical students matching into primary care, and especially into family medicine, may reflect the impact of health care reform discussions that have been focusing on the crucial need for a primary care-based health care system in the United States to improve access and cost-effective medical care.

A recent report from the Council on Graduate Medical Education said that the U.S. physician workforce needs to be made up of at least 40 percent primary care physicians -- up from the current 32 percent. Moreover, said the report, primary care physicians' average incomes should be increased to at least 70 percent of the median incomes of all other physicians.

However, although the family medicine match rate among U.S. medical school graduates has increased, most positions offered and filled in the NRMP, especially among U.S. graduates, continue to be in nonprimary care subspecialties.

According to the AAFP summary, a recent analysis of the link between physicians' starting salaries and specialty choice showed that U.S. seniors are choosing the more highly compensated specialties. Another troubling trend in recent years, says the summary, is "a dramatic increase in the income gap between primary care and other specialties."

"Until this issue is appropriately addressed, the AAFP believes that many excellent physicians will be deterred from a rewarding career in family medicine where patients and communities receive effective, equitable and efficient patient-centered care."