Match Day 2011: Family medicine grows, but enough to save primary care?

Match Day marks one of the most important days in a medical student’s career.

A computer algorithm “matches” prospective doctors with the residency program they’re destined go to.

It’s also a look at the future trends for various specialties.  With a major part of health reform about to be implemented, one naturally gravitates towards primary care, where there currently is a shortage of physicians.

Students who begin their primary care residency in 2011 will graduate in June of 2014, which is conveniently when 32+ million newly insured patients will start looking for doctors to be their primary care physicians.

Here’s the press release from the NRMP announcing the results of the 2011 Match:

Among primary care specialties, family medicine programs continued to experience the strongest growth in the number of positions filled by U.S. seniors.  In this year’s Match, U.S. seniors filled nearly half of the 2,708 family medicine residency slots.  Family medicine also offered 100 more positions this year.

The two other primary care specialties that increased in popularity among U.S. seniors were pediatrics and internal medicine.  U.S. seniors matched to 1,768 of the 2,482 pediatric positions offered, a 3 percent increase over 2010.  In internal medicine, U.S. seniors filled 2,940 of 5,121 positions, an 8 percent increase over last year.

Well, it’s certainly a small step in the right direction.  Although note that you can’t really factor internal medicine match rates into primary care trends, since the majority of internal medicine residents eventually will pursue medical subspecialties.

Even with the growth, less than half of American medical students matched into family medicine, compared to over 90% matching to specialties like dermatology, orthopaedic surgery, otolaryngology, plastic surgery, radiation oncology, thoracic surgery, and vascular surgery. Emergency medicine and anesthesiology also continued to be in high demand, with US medical graduates filling the majority of those positions.

The numbers continue to point to a substantial preference for US medical graduates to choose specialty medicine.  For regular readers of this blog, it’s no secret why: not only a substantial pay gap, but also a disparity in lifestyle, paperwork, and bureaucratic hurdles.

There’s a dire shortage of primary care doctors today.  The 2011 Match doesn’t lead me to believe that there will be a substantial change in that trend going forward.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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  • http://futureoffamilymedicine.blogspot.com mdstudent31

    Don’t forget the increase in family medicine in the Osteopathic match as well as Family medicine listed as one of the most competitive specialties in the military match.

    Also, remember that last year saw the highest gain since 2004 for family medicine, topped by this year’s highest in… who knows how long? Last year’s fill rate was also the highest ever… and that was topped again this year.

    It is a small step, followed by another small step. A change in attitude in current physicians malignant to primary care (including those in primary care) and appropriate advocacy gains will help this trend continue. Naysayers will be naysayers – it’s your choice to join them.

  • jsmith

    I admire mdstudents optimism, but no cure for fam med this year. Wait’ll next year, and the year after that and….

    • http://futureoffamilymedicine.blogspot.com mdstudent31

      jsmith! Buzz kill! The yin to my yang. If I could have put money on who would balance my enthusiasm out, it would have been you or PaulMD (one day Vegas will make this bet available).

      In any case, whether things change or not, it’s not like the past two years have shown negative results. Instead of raining on the parade, maybe we could make it a slight drizzle with a few rays of sunlight. Compromise?

      • buzzkillersmith

        Buzz kill. I really really like that a lot. You will go far, young man. ( assume you’re male, apologies if you’re not.)

  • jsmith

    Get serious, mdstudent. Look at the supply and demand in primary care. Put a fork in the PC medical system, it’s done. The parade has been washed away.
    That said, the future for individual PC docs looks better than a long sentence in state prison. At least there will be lots of jobs available. (Can’t you feel the love in this paragraph?)

  • soloFP

    Primary care docs are in the top three areas for recruitment in the Midwest and possibly nationwide. The other ones, besides IM/FM are orthopedics. There is a big salary discrepancy between the two, but primary care and specialties need each other to survive. Currently there is a shortage of primary care docs, but most of the specialist make 2-3 times what a typical primary care doc makes for around the same hours worked each week. Until the system values both specialists and primary care docs, the shortage will continue.

  • http://www.hopestreetgroup.org/index.jspa Joy Twesigye

    Great news for primary care! More could be considered better if the growth addresses maldistribution either by geographical relocation or telehealth. Physicians will be in high demand as chronicity of multiple conditions increase. Instead of worrying about flooding the market the physicians– which I feel is a low risk issue—What about focusing on how to redesign and amplify the workforce that we have now?

  • ninguem

    Is this growth reflecting interest in primary care, or inability to match in the specialties?

  • http://www.prescribingyoga.com Christina Palmer

    This is great news for family medicine! I think medical students are seeing the failings of the current system and realizing that big changes and new approaches in primary care are coming.

    Yes, there is a pay gap and current lifestyle of many family docs is not enviable…. but this will be changing, and it is up to us to offer new, innovative, and creative solutions. This makes family medicine an even more challenging and exciting field to go into.

    The opportunity for new ideas, innovative models, the use of technology and social media… this is all what drove me into family medicine and I could not be more excited to start FM residency in June.

    Thanks for such a great post!

  • drbestdeal

    I feel so much for all the FM guys. Its such a shame that the system keeps promising changes and better prospects and entices these young med grads. We all know that the changes are hard to come and the demand is not going to create any increase in pay for FM. Its all an eye wash and young, enthusiastic, honest docs like christine palmer fall for this field over and over again. what a pity!!!

  • Jill Bazeley

    You wrote: “The numbers continue to point to a substantial preference for US medical graduates to choose specialty medicine. For regular readers of this blog, it’s no secret why: not only a substantial pay gap, but also a disparity in lifestyle, paperwork, and bureaucratic hurdles.”

    Please don’t forget those who have a sincere interest in specialty medicine and who may be uniquely talented to practice in areas that go beyond primary care. The American College of Surgeons predicts there also will be a shortage of general and trauma surgeons. Due to the current narrow (but I agree necessary) focus on preventing a crisis in primary care, and because of the attitude that specialty medicine is all about lifestyle and compensation, suitable aspirants to surgical specialties meet with suspicion and scorn during medical school admissions.