Increased Quantity but Not Proportion: U.S. Medical Schools & Family Medicine Entry 2008-2018
FOR IMMEDIATE RELEASE: Friday, February 1, 2019
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A Rising Tide Does Not Lift All Boats
Allopathic Medical Schools’ Growth Doesn’t Translate into More Graduates in Family Medicine
WASHINGTON, DC —
Simply increasing the number of U.S. allopathic medical schools does not ensure a corresponding increase in graduates’ interest in family medicine.
That’s among the conclusions drawn by Robert Baillieu, MD, MPH, the immediate past Robert L Phillips Jr. Health Policy Fellow at the Robert Graham Center, whose research found that, despite an overall increase in first-year family medicine residents, the percentage of allopathic medical school graduates has remained stagnant.
Baillieu and colleagues analyzed National Resident Matching Program results from 2008 to 2018 to determine what percentage of first-year family medicine residents graduated from U.S. allopathic, osteopathic or international medical schools. The study, “Increased Quantity but Not Proportion: U.S. Medical Schools & Family Medicine Entry 2008-2018(www.graham-center.org),” was published in the February 1 issue of American Family Physician.
His results undercut the assumption that increasing the number of allopathic medical schools will automatically increase the percentage of allopathic graduates choosing family medicine. In fact, between 2008 and 2018, although the total number of U.S. graduates who entered family medicine training through the NRMP rose 64 percent, the annual proportion of allopathic medical school graduates who chose family medicine remained constant at around 50 percent, “well short of a peak in 1996, when 72.5 percent of first-year positions were filled by U.S. allopathic graduates.”
During the past decade, the percentage of U.S. osteopathic graduates who matched in to family medicine through the NRMP rose from 11 percent of new residents to nearly 20 percent. A rapid increase in osteopathic graduates matching through the NRMP since 2016 is attributable to a move towards a single accreditation system. Notably, over the same period, the proportion of U.S. citizens graduating from international medical schools who chose family medicine training grew from 17 percent to nearly 21 percent.
The question, Baillieu said, is why allopathic school graduates haven’t shown the same interest in family medicine as their osteopathic and U.S. international medical graduate counterparts?
“The mandate was to improve primary care participation by increasing the number of allopathic and osteopathic graduates,” he said. “The majority of the increase we see is in osteopathic and overseas medical school graduates. We need to look at why we aren’t getting an overall increase in allopathic medical school graduates.”
He pointed to data that cite multiple causes: traditional allopathic medical school practices that tended to recruit students more interested in procedures, pay differentials among specialties and students’ misperceptions about family medicine.
“We need to look at how family medicine markets itself and recruits students,” he said. “Primary care physicians are the first doctors people see, and then continue to see. Family physicians care for all ages, all conditions and practice in every environment. We are empowered to speak on behalf of the communities we serve. No other specialty does that. It is imperative that we reinvigorate how we market our specialty and recruit new colleagues. We must let all students know how important and exciting family medicine is.”
About the Robert Graham Center
The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.
Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.