Match Day celebrations were canceled at medical schools across the country in the wake of the COVID-19 pandemic, but family medicine still had reason to celebrate results of the National Resident Matching Program Main Residency Match that were released March 20.
Austin Witt, a fourth-year medical student at East Tennessee State University's James H. Quillen College of Medicine, celebrates Match Day with his family. Witt matched to the Duke Family Medicine Residency program in Durham, N.C.
Mikisa Solomon, a fourth-year medical student at the University of Pittsburgh School of Medicine, celebrates matching at the University of Pennsylvania Family Medicine Residency in Philadelphia.
Libby Wetterer, a fourth-year medical student at Georgetown University School of Medicine, shows off her Match letter from the family medicine residency at Montefiore Medical Center-Albert Einstein College of Medicine in the Bronx, New York.
Shelby Owens, a fourth-year medical student at Michigan State University College of Human Medicine, celebrates matching to the Mayo Clinic Family Medicine Residency in Rochester, Minn.
In the first entirely unified match for allopathic and osteopathic medical students, the total number of U.S. students and graduates matching into the specialty increased by 103 compared to last year's combined totals from the NRMP and the American Osteopathic Association's Intern/Resident Registration Program.
"Everything is getting overshadowed by the pandemic, but we hope that doesn't diminish the sense of accomplishment students should feel," said Clif Knight, the AAFP's senior vice president for education. "It's important to recognize this critical milestone in students' journey of transformation into physicians. We're certainly celebrating every new member of the family medicine workforce. This is a big deal, and we congratulate our new family medicine residents."
U.S. seniors from allopathic medical schools accounted for 1,557 positions (60 fewer than a year ago) filled in family medicine, while U.S. seniors from osteopathic medical schools accounted for 1,399 positions (410 more than last year's NRMP total and 104 more than last year's combined NRMP and AOA total).
Knight praised the osteopathic pipeline, which matched nine U.S. seniors into family medicine for every 10 allopathic U.S. seniors who matched into the specialty. Knight said that was "astonishing" considering that osteopathic schools have roughly one-third the number of overall U.S. graduates. Only 8.6% of U.S. allopathic seniors matched to family medicine residencies, compared to 23.4% of osteopathic seniors.
Importantly, the international medical school pipeline contributed strongly to the family medicine workforce again this year, with 25.5% of family medicine residency positions filling with 1,193 students and graduates of international medical schools, 78 more than last year.
Knight said that although there have been positive changes encouraging students to pursue family medicine, including the launch of new residency programs this year, he called on U.S. allopathic medical schools to do more to spur the growth of family medicine.
"We need every sector of the undergraduate medical education pipeline to recruit, support, expose, prepare and graduate students into those family medicine residencies," he said. "It is shameful and unacceptable that the sector of this undergraduate pipeline that is the largest, receives the most public funding and includes some of the most elite medical training institutions in the country graduates the smallest rate of students into family medicine."
In 2018, the AAFP set an ambitious goal of ensuring that by 2030, 25% of U.S. medical students pursue family medicine as their specialty. The percentage of U.S. seniors and graduates entering family medicine remained stable at 12.6% with the rise in osteopathic students offsetting the reduction in allopathic students.
"I'm excited by the Match numbers, but we want to see that percentage go up," said AAFP President Gary LeRoy, M.D., of Dayton, Ohio. "We're only halfway there as we start a new decade, but we're going to keep pushing."
Overall, a whopping 4,335 students and graduates -- 487 more than a year ago -- matched into family medicine. It was the 11th straight Match Day with year-over-year increases for the specialty and the ninth consecutive year that a record number of people matched into family medicine.
Family medicine's final total of new residents likely will be significantly higher because the results released March 20 did not include students who matched through the post-Match Supplemental Offer and Acceptance Program (SOAP). The specialty had 350 unfilled slots -- 70 more than a year ago -- due in part to the fact that nine family medicine residency programs received Accreditation Council for Graduate Medical Education accreditation in January and likely recruited during the SOAP process.
There also are expected to be more than 100 medical students who matched to family medicine in the December 2019 military match, but those results were not available.
"Despite that growth, we need to grow even more to meet the needs of our communities," Knight said. "The pandemic highlights the need for access to primary care. People are relying on frontline physicians -- family physicians -- across the country."
Knight said even more family medicine training slots are needed to meet the nation's demand for access to care, and one way to do that would be to provide stable, increased funding for primary care programs, including the Teaching Health Center Graduate Medical Education program. That program has been extended by short-term funding patches multiple times, but without congressional action the program, along with community health centers and the National Health Service Corps, will expire May 22.
The Academy included workforce programs among the priority issues it asked congressional leaders to support in its response to the COVID-19 pandemic in a March 19 letter.(4 page PDF) The AAFP also is urging members to contact their members of Congress in support of teaching health centers via the Speak Out tool.(www.votervoice.net)
LeRoy said the pandemic has given the Academy more opportunities to communicate with the administration and federal agencies about the need to support primary care programs, including those facing a May expiration date. It also has given family physicians opportunities to talk with the media about what is happening in their communities as COVID-19 spreads.
"I'll be very interested to see how the Match looks for family medicine in 2021," LeRoy said, "after the nation and the world see how our specialty was the essential ingredient necessary to get us through this crisis."