Trends in the Contribution of US Medical Schools to the Family Medicine Workforce

Context: Multiple studies have identified a substantial primary care workforce shortage, worsening with time. Rising rates of burnout and early retirement from the COVID-19 pandemic have exacerbated this problem. The family medicine training pipeline contributes the largest proportion of its trainees to the primary care workforce.

Objective: Understand trends in the proportion of medical students entering family medicine training and factors at the student and institutional level that impact these trends.

Study Design and Analysis: A retrospective study of graduates of medical schools. The analysis includes (1) an examination of trends in the composition of physicians matriculating in family medicine residency programs, (2) bivariate and multivariate analyses of school characteristics associated with such matriculation.

Dataset: AAFP annual family medicine program census data, 2010-2020, collapsed to the Medical School level.

Outcome Measures: Proportion of total US medical school graduates who matriculated into family medicine residencies.

Results: Between 2010 and 2020 the percent of US medical school graduates who matriculated into family medicine residencies rose from 9.3% [=1,930/20,712] in 2010 to 12.5% [3,478/27,768] in 2020. This pattern reflects the growing number of graduates from osteopathic medical schools, rising from 3,631 in 2010 (566 entering FM) to 6,879 in 2020 (1,606 entering FM). This pattern offsets the declining number of US medical students in public schools, which has historically produced many graduates matriculating in FM. The results hold up in regression analyses. From 2010 to 2020, the adjusted annual increase in the percent of US graduates entering FM increased 0.34 percent [95% CI: 0.26-0.43%]. Matriculation in family medicine is 10.2% [95% CI: 9.61-10.85%] higher for osteopathic graduates than allopathic graduates.

Conclusions: This data examine the trends in production of family medicine residents and highlight school characteristics associated with matching into a family medicine residency. As we move towards eliminating the primary care workforce shortage, we must continue to support policies that foster the growth of learning environments that produce primary care physicians.