Once again, family medicine has topped its own record! Recruits to the specialty hit an all-time high in the 2017 National Resident Matching Program (NRMP), with 3,237 medical students and graduates choosing family medicine residency programs today.
Matt Peters poses with his wife Samantha at the University of Washington School of Medicine in Seattle shortly after learning that his next stage of medical training will take the couple to Cascades East Family Medicine Residency in Klamath Falls, Ore.
That's right. Numbers are just in from this annual event, commonly referred to as the Match, and the record-breaking total represents an increase of 132 positions filled in family medicine compared to 2016 figures.
Notably, this marks the eighth consecutive year that the number of students entering family medicine has increased. AAFP Match calculations have always included students matching into traditional family medicine residency programs, as well as programs that combine family medicine education with other focused training.
Those additional programs are family medicine/emergency medicine, family medicine/preventive medicine, family medicine/medicine and family medicine/psychiatry.
The number of positions offered in 2017 went up, as well. This year's Match saw 3,378 family medicine positions offered, or 118 additional spots compared to last year. The 2017 fill rate -- that is, the percent of offered positions that were filled -- was 95.8 percent, a slight uptick from 2016.
- In the 2017 National Resident Matching Program, family medicine set a new record high for matching residents to the specialty.
- A record 3,237 medical students and graduates chose family medicine residency programs, ensuring an increase in numbers for eight years running.
- The AAFP acknowledged that continued slow and steady growth won't be enough to meet the nation's long-term needs.
When looking at U.S. seniors, the upward trend continues; 1,530 chose family medicine in the 2017 Match, an increase from 1,481 last year.
"First and foremost, today is a time of celebration for these new family medicine recruits," said AAFP President John Meigs, M.D., of Centreville, Ala., in an interview with AAFP News. "The AAFP applauds their accomplishments and welcomes them. These new residents have accepted the challenge to commence the most complex medical specialty training around.
"By joining the ranks of family physicians, they will learn to provide the comprehensive, compassionate and continuous care that leads to better health, better care and the wisest use of resources," said Meigs. "Communities all across the country will benefit when these family medicine residents arrive for training."
Persistent Primary Care Shortage
The celebratory nature of the 2017 Match should be tempered with a dose of reality; simply stated, the numbers announced today must accelerate in the future to meet the nation's long-term needs.
"We've seen a slow and steady upward trend for eight years now, but slow is not good enough," said Meigs. "Slow is not going to cut it."
Indeed, in 2015, researchers from the Robert Graham Center for Policy Studies in Family Medicine and Primary Care projected that the shortage of primary care physicians will reach 33,000 by 2035. Their summary article,(www.annfammed.org) published in the March/April 2015 Annals of Family Medicine, calls for an increase in the number of primary care residency slots.
Kelsey Murray sports a big smile during Match day celebrations at Ohio State University College of Medicine in Columbus after learning that she's matched to the Family Medicine Residency at OhioHealth Grant Medical Center, also in Columbus. Murray currently serves as the national network coordinator for family medicine interest groups across the country.
Stan Kozakowski, M.D., director of the AAFP's Division of Medical Education, told AAFP News that new slots largely come from new programs. And there has been an uptick there, as well. In fact, the number of family medicine residency programs has increased by nearly 13 percent in the past five years, from 472 programs to 532.
"That's encouraging but it's not enough; we need more programs and we need more graduates," said Kozakowski. "About 15 percent of all positions offered in this year's Match are in primary care, and that will not get us to where we need to be."
That statement mirrors results of a study(www.stfm.org) published in the November/December issue of Family Medicine. In that article, authors point out that strong subspecialty growth is disproportionate to that of primary care.
Researchers note that since 1986, the overall number of positions offered in the Match increased an average of 226 positions per year. And of those, positions in E-ROAD subspecialties (defined as emergency medicine, diagnostic radiology, ophthalmology, anesthesiology, dermatology and others) increased by an average 72 positions per year.
But during the same 30-year time span, primary care specialties increased by an average of just 19 positions per year.
"As it stands now, the very modest increase in primary care positions is far outpaced by that of subspecialties," said Kozakowski.
However, suggestions for a fix are on the table.
"The AAFP has a budget-neutral plan(7 page PDF) that was publicly unveiled in September 2014 in Washington, D.C. That plan, if implemented, would increase the number of graduate medical education positions in primary care and family medicine," said Kozakowski.
However, "The overarching issue is that our nation lacks an oversight process for graduate medical education, as recommended by an Institute of Medicine report(www.nationalacademies.org) released in July 2014," he added.
Stirring, Sustaining Student Interest
So what's the best way to get students hooked on family medicine and sustain that interest right up to Match day?
"We need to start by steering the right folks into medical school: bright young men and women of diverse backgrounds and locations -- including rural, urban and underserved areas -- who are most likely to return to their communities to practice medicine," said Meigs.
"I call on my family physician colleagues to actively participate in opening the eyes of medical students to our specialty. We can spark their curiosity by inviting them into our practices, giving them a glimpse of family medicine up close and personal, and allowing them to see and feel the difference a family physician can make in a community."
Meigs said medical schools play a pivotal role, too.
"U.S. medical schools must be held accountable for continuing to underproduce the physician workforce this country needs," said Meigs. "These schools and their academic medical centers need to emphasize, promote and nurture a respect for primary care, because research shows us that primary care -- and particularly family medicine -- improves health care quality and lowers the cost."
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