A Perfect Match? No, But for Primary Care, a Promising One

Today is a big day for young doctors in two ways. It's Match Day, which means graduating medical students nationwide are finding out where they'll be doing their residencies. And it's an encouraging day for family medicine, because 1,169 of this year's American graduates have chosen to go into that field, a significant increase from last year. This is good news for embattled and over-scheduled primary-care docs, for health-care reformers who promote preventive medicine, and for the rest of us who often find it hard to get an appointment for a checkup: it's a sign that we're starting to make some progress—albeit not enough—on the primary-care crisis.

As we noted a few weeks ago, the number of docs entering primary care has been dropping steadily since 1997, when it was twice what it is now. Last year was especially bleak; it saw a 7 percent dip in applicants to family-medicine programs from the previous year. Now that number is back up by 9 percent. (Talk about bending the curve!) Family medicine is only one type of primary care, but two related primary-care fields—internal medicine and pediatrics—also saw small rises in applications this year, of 3 and 2 percent respectively.

Why are more med students suddenly interested in primary care? Maybe some of the scholarships we mentioned in our article—"dozens of training programs like Tufts's around the country, as well as the National Health Service Corps, which pays back loans and hands out scholarships and stipends in exchange for a few years of service in rural areas, where the shortage of primary-care providers is most acute"—are working. That must be heartening to health-care-reform advocates: the House bill, the Senate bill, and the president's proposal all call for expansions of those programs.

But it's important to remember that the new numbers are by no means a sign that the primary-care crisis has been solved. One doc we interviewed said that half of American doctors should be delivering primary care. (Currently, about 30 percent do.) Just 5,602 of the 16,000 new American medical grads chose family medicine, internal medicine, or pediatrics. In other words, yes, there's been a small bump in primary-care applicants, but we need a bigger one. The American College of Physicians agrees: today's higher numbers are "not enough to significantly impact the shortage of primary-care physicians."

Let's look at a different statistic: 2,608, which is the number of training slots in family medicine that were available this year. More of those slots—1,439 of them—went empty than got filled by American applicants today. (Most of the positions will still end up filled, either by international graduates—who already make up a quarter of the medical workforce—or by American students who didn't find a home in the first-round Match and are participating in a second-round "Scramble" for the remaining slots.) Meanwhile, highly specialized medical fields continue to lure bright young grads: The group that administers the Match says, "Neurological surgery, orthopedic surgery, dermatology, and otolaryngology were the most competitive fields for applicants [this year]. At least 90 percent of those positions were filled with U.S. medical-school seniors." Until primary care gets to boast about this magnitude of stat, we won't consider the crisis over.

P.S.: There's one more interesting piece of data coming out of the Match results today. Apparently, this was the biggest Match in history, with 30,543 applicants, an astonishing 3,800 more than there were in 2006. The translation is that medicine may be in an upheaval thanks to rising costs and the uncertainty surrounding health-care reform, but young people still want to become doctors.

A Perfect Match? No, But for Primary Care, a Promising One | News