FAMILY MEDICINE WELCOMES LARGEST CLASS OF RESIDENTS EVER

I believe our Match results for this year only show continued worrisome trends.

The surge in Family Medicine (both in matched applicants and in positions offered) in the last 5 years is largely artificial due to the single accreditation system process and disappearance of the DO match in 2020 (800+ DOs incorporated from 2018 to 2022). DO graduates choosing DO family medicine programs have always been here, just never on our graphs before. US seniors choosing Family Medicine has been in decline since 2018, to a new 5-year low this year of 1541. The small numerical increase in DOs choosing Family Medicine is not re-assuring given the percentage still went down.

We have not had a significant real increase in numbers since the 1990s with the anticipated boom in managed care, which culminated in our apex of 2340 in 1997. Unfortunately with the managed care "bust" by 2001 we were back to 1503 (35% drop in 4 years). Positions over that decade mirrored the match results' rise and fall, with many programs not surviving into the new century.

So over the last 2 decades we have registered less than 3% total growth in US grads matched. We have seen some increase in programs and positions beyond the absorption of DO programs, but those new positions have largely been filled by US IMGs. Despite the growth of offshore medical schools the US IMG pool is very limited and contributes less than 20% of our total PGY1 pool.

On the bright side Family Medicine is still the largest specialty (if we divide internal medicine by sub-specialty). On the dark side we’ve failed to increase the number of US seniors choosing FM, with the FM percentage of all US grads declining to 8.3% this year, despite well publicized and applauded targets from the experts of the past recommending 25% - 50% of US graduates entering primary care.

I think we are in a recruiting crisis for US medical school graduates. While we’ve remained stagnant for 20 years the US population has increased 18%, from 282 million to 332 million. The gap in available primary care is increasingly being made up by mid-level providers, urgent care, complex care/lipid/DM specialty clinics, etc., many of which are cheaper up front and/or feed sub-specialty care more voluminously. Although we understand the value of the primary care we deliver to patients and society, this value is unfortunately not always reflected in health systems' annual budgets, so the more patient share we cede to other primary care sources, the less our value and our voice will be seen and heard.

Our progress in establishing medical school Family Medicine departments and required clerkships has not yielded the recruiting dividends we expected. I hope our specialty leadership recognizes this existential threat and addresses it with the urgency it deserves.