Editor's Note: This story was modified on Nov. 23 to indicate that Wisconsin, not Pennsylvania, belongs in the East North Central region that saw the lowest Match fill rate.
The 2011 National Resident Matching Program, also known as the Match, generated good news in terms of the number of medical students matching into family medicine residencies, but a closer examination of those results reveals that the small, incremental increases in interest in family medicine seen may not paint as rosy a picture as it first seems.
An in-depth analysis of data collected from the 2011 Match, along with a survey of all 451 U.S. family medicine residency programs, suggests that although interest in family medicine is increasing, the medical education system still is not producing the number of family physicians needed in the United States.
"Despite matching the highest number of U.S. seniors into family medicine residencies since 2002, the production of family physicians remains insufficient to meet the current and anticipated need to support the nation's primary care infrastructure," said the authors of "Results of the 2011 National Resident Matching Program: Family Medicine(www.stfm.org)," in the October Family Medicine.
The authors, who are in the AAFP's Division of Medical Education, concluded that the percentage of U.S. seniors choosing primary care careers "still remains well below the nation's needs."
- An annual analysis of data from the 2011 National Resident Matching Program, or the Match, and a survey of family medicine residency directors provide a snapshot of residents entering programs in 2011.
- The 2011 Match program matched the highest number of U.S. seniors into family medicine residencies since 2002.
- Although family medicine is showing small, incremental gains in boosting the number of potential family physicians, the U.S. graduate medical education system still is not producing a sufficient number of family physicians to meet the country's needs.
But, there is promising news, too. For the second year in a row, Match results indicated an increase in the number of medical students choosing careers in primary care. In addition, the article's authors noted that the AAFP's student membership ranks swelled to 16,700 student members in early 2011, an 18 percent increase from 2010. This means there is an increase in the pipeline of potential future family medicine residents.
Wendy Biggs, M.D., lead author of the article and assistant director in the Medical Education Division, told AAFP News Now that the 2011 family medicine Match fill rate of 94.4 percent -- or 2,730 family medicine positions offered and 2,576 filled -- lends some credence to the assumption "that the quality of the pool is improving, and family medicine is taking more people in the Match."
The problem, said Biggs, is that, "Right now, we don't have enough medical students going into primary care to replace the primary care physicians who are retiring." She added that the 20th Council on Graduate Medical Education report states that 40 percent of the nation's physician workforce needs to be engaged in primary care to match the health care needs of the American public.
The report in Family Medicine compares 2010 and 2011 Match statistics and gives readers a snapshot of the composition of residents entering programs in July 2011. For example, the authors found that
- 2,730 first-year positions in family medicine resident programs were offered in 2011, or 100 more positions than in 2010;
- 2,576 of those positions were filled through the Match, representing an increase of 172 positions from 2010;
- 1,317 U.S. seniors matched into family medicine residencies, or 133 more than in 2010;
- 8 percent of all U.S. seniors participating in the Match chose family medicine compared to 7.4 percent in 2010; and
- 48.2 percent of family medicine positions in 2011 were filled by U.S. seniors with an M.D. degree.
An article in the October issue of Family Medicine that looks at trends among medical school graduates entering family medicine residencies found some interesting facts.
"Entry of U.S. Medical School Graduates Into Family Medicine Residencies: 2010-2011 and 3-year Summary(www.stfm.org)" represents the 30th national study conducted by the AAFP to determine the percentage of graduates from each medical school entering family medicine residency programs. The study found that
- 95 percent of graduates of family medicine residency programs still practice primary care five years after graduation from medical school, but only 21 percent of internal medicine residency graduates do so;
- medical schools that support a department of family medicine are more likely to produce graduates who enter a family medicine residency program; and
- 10 U.S. medical schools do not have a department or division of family medicine, including Harvard Medical School, which, however, launched its Center for Primary Care in October 2010.
In addition, 1,259 "other" graduates matched in family medicine in 2011, including 363 non-U.S. citizens educated internationally, 294 graduates of colleges of osteopathic medicine, and 504 U.S. citizens educated internationally.
Geographically, family medicine residency programs in the Pacific region showed the highest fill rate, at 99.5 percent; the East North Central region of the country -- encompassing Illinois, Indiana, Michigan, Ohio and Wisconsin -- fared the worst, at 89 percent.
Match fill rates in different geographic regions of the country are not equal, noted Biggs. Geographic issues may have an impact on the Match rates of certain residency programs because young people have a preference for the West Coast and the southern regions of the United States, she said.
The authors also detected a steady uptick in the number of D.O. physicians choosing family medicine. For example, graduates of colleges of osteopathic medicine filled 633 first-year positions in July 2011, compared with 599 in 2010 and just 232 in 1994. "Osteopathic graduates selecting allopathic family medicine programs is expected to increase due to more dually accredited family medicine residency programs," said the authors. The number of such programs grew from just 26 in 2003 to 111 in 2011.
Regarding international medical graduates, or IMGs, the article's authors said IMGs continue to represent a good portion of residents in many medical specialties, including family medicine, but that trend may be changing. In the future, IMGs "may face increasing competition for limited residency positions," for a variety of reasons, said the authors.
With new allopathic and osteopathic medical schools opening and increasing enrollment at existing medical schools, non-U.S. citizen medical graduates may have even more difficulty entering family medicine residencies, concluded the authors.
"If this trend continues, we're going to be looking at (non-U.S. citizen) IMG levels back at (lower) 2000 levels," said Biggs. She added that residency program concerns about timely procurement of visas for noncitizen residents have cut into the number of noncitizen IMG residents.
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