Entry of US Medical School Graduates Into Family Medicine Residencies: 2009-2010 and 3-year Summary

From the assistant director (Dr McGaha) director (Dr Pugno), and data and information specialist (Mr Crosley), Division of Medical Education; director, Division of Research and Information Services (Mr Schmittling); and manager, Student Interest, Division of Medical Education (Ms Bieck), American Academy of Family Physicians, Leawood, Kan. Following a decade of declining numbers of students choosing family medicine, the results of the 2010 National Residency Matching Program (NRMP) demonstrate the highest number of US seniors choosing family medicine since 2004.1 NRMP results also demonstrate medical students’ overall continued preference for subspecialties coupled with a decline in US students choosing pediatrics primary care and a continued low number of students choosing internal medicine primary care. There was an increase in the number of students choosing internal medicine-pediatrics combined programs (299 versus 241 in 2009). Many factors influence US medical student specialty choice, and the interrelationship of these factors is complex. Specific factors shown to influence student choice of family medicine include both individual student characteristics as well as educational and curricular elements. The American Academy of Family Physicians (AAFP) recognizes four clearly identified areas of focus that are associated with increased selection of family medicine—communications and image, admissions and pipeline, role models, and curriculum and education.2 The AAFP and other family medicine organizations continue to develop interventions within these four areas of focus. The AAFP supports the inclusion of a required third-year clerkship in family medicine as well as the presence of a strong department of family medicine on campus, as both are correlated with increased specialty selection of family medicine.3,4 In 2010, the AAFP launched a new student interest initiative that seeks to build regional student interest collaboration and infrastructure among the various student interest stakeholder groups. While factors related to lifestyle and educational debt have not conclusively been found to have a direct impact on specialty choice,5-9 recent data show that these issues have become increasingly influential.10,11 Growing evidence supports the idea that payment reform must address the growing primary care-specialty income This is the 29th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school’s graduates entering family medicine residency programs. Approximately 7.5% of the 16,617 graduates of US medical schools between July 2008 and June 2009 were first-year family medicine residents in 2009, compared with 8.2% in 2008 and 8.3% in 2007. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2009 than were residents from privately funded schools, 8.8% compared with 5.3%. The Mountain and West North Central regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2009 at 13.4% and 11.0%, respectively; the New England and Middle Atlantic regions reported the lowest percentages at 7.0% and 4.4%, respectively. Nearly half of the medical school graduates (48.3%) entering a family medicine residency program as first-year residents in October 2009 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine. These numbers are retrospective analyses based on numbers reported to the AAFP from medical schools and family medicine residency programs.