After 2 years of notable increases in the number of U.S. medical students choosing primary care residencies, figures from this year’s National Resident Matching Program show interest remains level.
Both the percentage and the actual number of U.S. medical students matching to residencies in family medicine, internal medicine, and pediatrics were fairly similar to figures from 2011.
Leaders in primary care said more work needs to be done to make careers in primary care attractive by closing the income gap between primary care physicians and specialists and by recognizing the importance of primary care physicians in improving health and lowering costs.
"It’s partly financial and it’s partly an issue of the status and stature," said Dr. Steven Weinberger, executive vice president and CEO of the American College of Physicians.
Dr. Weinberger said that, in addition to payment reform, medical students need to see that there’s a societal recognition of the role primary care physicians play in caring for increasingly complex patients.
The Affordable Care Act, with its emphasis on primary care, has helped to improve the status of the field among medical students, said Dr. Glen Stream, president of the American Academy of Family Physicians. But it hasn’t done enough.
There needs to be more done to address medical education debt, Dr. Stream said, and to change the medical education system so that medical schools are held accountable for producing primary care physicians.
Medical schools should be recruiting students with an interest in primary care and nurturing that interest throughout their education, he said.
Although the number of U.S. medical school seniors choosing residents in family medicine crept up slightly, Dr. Stream said that AAFP had been hoping for a bigger increase based on anecdotal reports from residency directors about the high level of interest among applicants this year. While any increase is positive, Dr. Stream said primary care has a lot of catching up to do. "We know we’re so far behind in having an adequate family medicine workforce," he said.
In 2012, 2,740 family medicine residency positions were offered. Of those, 94.6% were filled, with 48.2% filled by U.S. medical graduates. That compares with 2011, when 48% of the 2,708 positions were filled by U.S. graduates.
In internal medicine, more positions were added to this year’s resident match, but most were filled by international medical graduates. Overall, 5,277 internal medicine positions were offered in 2012. Of those, 99% were filled, with 55.7% of the slots being taken by U.S. medical graduates. In 2011, 57.4% of the 5,121 positions offered were filled by U.S. medical graduates.
In pediatrics, interest by U.S. medical students was also fairly consistent. This year, 98.7% of the total 2,475 positions offered were filled. U.S. medical graduates filled 70% of the pediatric positions. In 2011, U.S. medical graduates accounted for 71.2% of the 2,482 available slots.
Emergency medicine was a popular choice among residents this year. All of the 1,668 positions were filled, with 80% being taken by U.S. medical graduates.
Dermatology, orthopaedic surgery, otolaryngology, plastic surgery, radiation oncology, thoracic surgery, and vascular surgery were the most competitive fields in this year’s match, according to the National Resident Matching Program.