Medical school students are increasingly choosing family medicine, internal medicine and pediatrics, according to the latest data from the National Resident Matching Program (NRPM). Released last week, the NRPM’s Main Residency Match showed that primary care matches rose by almost 400 compared to 2012 figures.
The total number of Match registrants topped 40,000 for the first time, according to NRPM Executive Director Mona Signer. “We attribute the rising number of U.S. students to three new medical schools graduating their first classes as well as enrollment expansions in existing medical schools,” Signer said in a prepared statement.
NRMP reported that in addition to students from U.S. medical schools, the 2013 Match included:
• 2,677 students and graduates of osteopathic schools -- an increase of 317 over 2012 and up more than 600 over five years.
• 5,095 U.S. citizen students/graduates from international medical schools (IMGs) -- 816 more than in 2012 and up more than 1,700 over five years.
• 7,568 non-U.S. citizen students/graduates of international medical schools (IMGs) -- 740 more individuals over 2012.
U.S. medical school seniors made up 16,390 of the 25,463 applicants who successfully matched to first-year residency positions. With a match rate exceeding 90 percent, they are the most successful applicants in the Match. Notable this year, however, are the results for U.S. citizen IMGs and foreign-national IMGs, whose match rates increased by 4 and 7 percentage points, respectively, according to NRPM. The overall match rate for applicants to first-year positions rose by 1 percentage point to 74.1 percent.
Of the applicants who matched, 78.8 percent of U.S. seniors and 78.8 percent of independent applicants matched to one of their top three choice programs. More than half of U.S. seniors and almost half of independent applicants matched to their first choice.
The total number of positions offered in the Match was 29,171, an increase of 2,399 over last year and an all-time high. “The significant increase in positions was due to a change in NRMP policy that requires Match- participating programs to register and attempt to fill all positions in The Match,” said Signer in her prepared statement. This year 1,000 more internal medicine positions were placed in the Match, along with 297 more in family medicine and 141 more in pediatrics.
Match results can be an indicator of career interests among U.S. medical school seniors, said NRPM. Among the notable trends this year:
• 3,135 U.S. seniors matched to internal medicine, an increase of 194 over last year.
• 1,837 U.S. seniors matched to pediatrics, an increase of 105 over last year.
• Family medicine matched 1,355 U.S. seniors, 33 more than last year. More than 95 percent of family medicine positions were filled.
• Emergency medicine programs offered 1,744 positions, 76 more than last year, and filled all but three of them.
• Anesthesiology programs offered 1,653 positions, 177 more than last year, and filled all but 62 of them.
• Specialties with at least 50 positions in the Match that filled at least 80 percent of positions with U.S. seniors were dermatology, emergency medicine, medicine-pediatrics, neurological surgery, orthopedic surgery, otolaryngology, radiation oncology, general surgery and plastic surgery.
Stan Kozakowski, MD, director of the American Academy of Family Physician's Medical Education Division, said that 2013 marked the first time since 2001 that the number of family medicine residency positions topped 3,000. He attributed part of that increase to a rise in the number of new family medicine residency programs.
"Between January 2012 and March 2013, 18 new family medicine residences were approved by the Accreditation Council for Graduate Medical Education," said Kozakowski in a news release. "We calculated the programs could account for 72 to 126 new positions in 2013."
Steven Weinberger, MD, executive vice president and CEO of the American College of Physicians (ACP), the nation’s largest medical specialty organization, said in a news release, “We are pleased that more U.S. medical students are choosing internal medicine residencies and hope the upward trend continues. However, ACP remains concerned about the need to increase the nation’s general internal medicine physician workforce to meet the needs of an aging population requiring care for chronic and complex illnesses and the increased number of individuals who will be receiving coverage through the Affordable Care Act.”
The 2013 match for internal medicine is still well below the 3,884 U.S. medical school graduates that chose internal medicine residency programs in 1985, according to ACP.
Weinberger cited problematic payment models and the cost of medical education -- with the resulting financial burden on medical students and residents -- as barriers to a career in general internal medicine.