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Am Fam Physician. 2005;72(3):392

Graduates of U.S. allopathic schools have filled less than one half of the family medicine positions offered in the National Resident Matching Program (NRMP) Match since 2001. Overall fill rates in July have been relatively stable at approximately 94 percent. Family medicine has become reliant on international medical graduates (IMGs), who in 2004 made up 38 percent of first-year residents.

During the early 1990s, family medicine training positions increased by more than one third, adding about 900 positions, and the specialty enjoyed a revival of medical student interest.1 Allopathic graduates’ interest in family medicine has fallen precipitously since its height in 1996, when allopathic graduates filled almost three out of four training positions. Despite a poor fill rate in the NRMP Match each March (Table 1),2 by the start of the internship year in July, around 94 to 97 percent of positions are filled (Table 2).3

1998199920002001200220032004
Positions available3,2933,2443,1833,0742,9622,9202,864
Percentage filled by U.S. seniors66625749474241
Percentage filled by IMGs10131516202426
Percentage filled85838276797679
1998199920002001200220032004
Positions available3,7233,6443,6233,5283,5233,4803,501
Percentage filled by IMGs15151930323838
Percentage filled96979696959694

The absolute number of allopathic students currently choosing family medicine has declined only slightly compared with the period before the 1990s; but in the context of the larger number of medical residency positions available, the decline has been steep. The combination of a substantial increase in family medicine training positions and a drop in U.S. medical graduates’ interest has yielded an almost threefold rise in the number of IMGs who fill first-year family medicine positions. In 2004, IMGs composed 38 percent of first-year family medicine residents, up from 15 percent in 1998. Currently, IMGs make up about 16 percent of the family medicine physician workforce. It remains to be seen how this internationalization of family medicine will affect the specialty in the United States, and medicine as a whole worldwide.

The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP.

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

A collection of Graham Center Policy One-Pagers published in AFP is available at https://www.aafp.org/afp/graham. One-Pagers are also available at https://www.graham-center.org.

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