Entry of US medical school graduates into family medicine residencies: 2006-2007 and 3-year summary

This is the 26th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. Approximately 8.5% of the 16,110 graduates of US medical schools between July 2005 and June 2006 were first-year family medicine residents in 2006, compared with 8.4% in 2005 and 9.2% in 2004. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2006 than were residents from privately funded schools, 10.1% compared with 6.0%. The West North Central and the Mountain regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2006 at 12.4% and 10.7%, respectively; the New England and Middle Atlantic regions reported the lowest percentages at 5.7% and 5.6%, respectively. Nearly half of the medical school graduates (49.2%) entering a family medicine residency program as first-year residents in October 2006 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Entry of US medical school graduates into family medicine residencies: 2010-2011 and 3-year summary

This is the 30th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. This retrospective analysis based on data reported to the AAFP from medical schools and family medicine residency programs shows approximately 8.0% of the 17,081 graduates of US medical schools between July 2009 and June 2010 were first-year family medicine residents in 2010, compared to 7.5% in 2009 and 8.2% in 2008. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2010 than were residents from privately funded schools (9.6% versus 5.4%). The Mountain and West North Central regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2010 (14.3% and 11.3%, respectively); the New England and Middle Atlantic regions reported the lowest percentages (5.6% and 5.3%, respectively). Approximately four in 10 of the medical school graduates (40.3%) entering a family medicine residency program as first-year residents entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the 3-year average percentage from each medical school of graduates entering family medicine residencies and the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs in 2010.     

Entry of US medical school graduates into family medicine residencies: 2007-2008 and 3-year summary

This is the 27th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. Approximately 8.3% of the 16,300 graduates of US medical schools between July 2006 and June 2007 were first-year family medicine residents in 2007, compared with 8.5% in 2006 and 8.4% in 2005. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2007 than were residents from privately funded schools, 10.0% compared with 5.6%. The West North Central and the Mountain regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2007 at 12.2% and 11.9%, respectively; the New England and Middle Atlantic regions reported the lowest percentages at 5.5% and 4.7%, respectively. Nearly half of the medical school graduates (46.5%) entering a family medicine residency program as first-year residents in October 2007 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Entry of US medical school graduates into family medicine residencies: 2004-2005 and 3-year summary

This is the 24th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. Approximately 9.2% of the 15,895 graduates of US medical schools between July 2003 and June 2004 were first-year family medicine residents in 2004, compared with 9.3% in 2003 and 10.3% in 2002. Medical school graduates from publicly funded medical schools were more likely to be first year family medicine residents in October 2004 than were residents from privately funded schools, 10.8% compared with 6.5%. The West North Central and the Mountain regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2004 at 14.9% and 12.8%, respectively; the New England and Middle Atlantic regions reported the lowest percentages at 6.6% and 5.2%, respectively. Nearly half of the medical school graduates (46.8%) entering a family medicine residency program as first-year residents in October 2004 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Entry of US medical school graduates into family medicine residencies: 2003-2004 and 3-year summary

This is the 23rd report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. Approximately 9.3% of the 15,704 graduates of US medical schools between July 2002 and June 2003 were first-year family medicine residents in 2003, compared with 10.3% in 2002 and 10.9% in 2001. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2003 than were residents from privately funded schools, 10.6% compared with 7.0%. The West North Central and the Mountain regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2003 at 15.2% and 11.7%, respectively; the New England and Middle Atlantic regions reported the lowest percentages at 6.2% and 5.3%, respectively. Nearly half of the medical school graduates (46.1%) entering a family medicine residency program as first-year residents in October 2003 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Entry of US medical school graduates into family practice residencies: 1999-2000 and 3-year summary

This is the 19th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family practice residency programs. Approximately 13.4% of the 16,143 graduates of US medical schools between July 1998 and June 1999 were first-year family practice residents in 1999, compared with 15.4% in 1998 and 16.6% in 1997. Medical school graduates from publicly funded medical schools were almost twice as likely to be first-year family practice residents in October 1999 than were residents from privately funded schools, 16.2% compared with 9.3%. The West North Central region reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 1999 at 20.6%; the Middle Atlantic and New England regions reported the lowest percentages at 7.7% and 8.0%, respectively. Nearly half of the medical school graduates (48.4%) entering a family practice residency program as first-year residents in October 1999 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family practice residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Entry of US medical school graduates into family practice residencies: 2000-2001 and 3-year summary

This is the 20th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family practice residency programs. Approximately 12.8% of the 15,825 graduates of US medical schools between July 1999 and June 2000 were first-year family practice residents in 2000, compared with 13.4% in 1999 and 15.4% in 1998. Medical school graduates from publicly funded medical schools were almost twice as likely to be first-year family practice residents in October 2000 than were residents from privately funded schools, 15.6% compared with 8.7%. The West North Central region reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 2000 at 18.2%; the Middle Atlantic and New England regions reported the lowest percentages at 8.3% and 6.8%, respectively. Nearly half of the medical school graduates (47.0%) entering a family practice residency program as first-year residents in October 2000 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family practice residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Entry of US medical school graduates into family practice residencies: 2002-2003 and 3-year summary

This is the 22nd report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family practice residency programs. Approximately 10.3% of the 15,810 graduates of US medical schools between July 2001 and June 2002 were first-year family practice residents in 2002, compared with 10.9% in 2001 and 12.8% in 2000. Medical school graduates from publicly funded medical schools were more likely to be first-year family practice residents in October 2002 than were residents from privately funded schools, 12.3% compared with 7.3%. The Mountain and the West North Central regions reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 2002 at 16.3% and 15.9%, respectively; the Middle Atlantic and New England regions reported the lowest percentages at 6.1% and 5.6%, respectively. Nearly half of the medical school graduates (48.6%) entering a family practice residency program as first-year residents in October 2002 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family practice residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Entry of US medical school graduates into family practice residencies: 2001-2002 and 3-year summary

This is the 21st report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family practice residency programs. Approximately 10.9% of the 15,900 graduates of US medical schools between July 2000 and June 2001 were first-year family practice residents in 2001, compared with 12.8% in 2000 and 13.4% in 1999. Medical school graduates from publicly funded medical schools were more likely to be first-year family practice residents in October 2001 than were residents from privately funded schools, 12.7% compared with 8.4%. The West North Central region reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 2001 at 15.2%; the Middle Atlantic and New England regions reported the lowest percentages at 8.0% and 7.2%, respectively. Nearly half of the medical school graduates (48.0%) entering a family practice residency program as first-year residents in October 2001 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Councilfor Graduate Medical Education-accreditedfamily practice residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Geriatric medicine training for family practice residents in the 21st century: a report from the Residency Assistance Program/Harfford Geriatrics Initiative

Increasing the quality and quantity of geriatric medicine training for family practice residents is a particular challenge for community-based programs. With support from the John A. Hartford Foundation of New York City, the American Academy of Family Physicians (AAFP) implemented in 1995 a multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. This report summarizes the initial results of the regional geriatric medicine curriculum retreats for residency directors. The goals of the retreats were to build recognition among the residency directors of the skills that future family physicians will require to be successful providers of primary care to older adults and to allow the residency directors to identify and develop solutions to barriers to improving geriatric medicine training for residents. Forty-six program directors participated in the three retreats between February 2000 and February 2001. The participants represented 52 programs and rural tracks in all geographic regions, small and large programs, and urban and rural settings. The program directors developed a consensus on the geriatric medicine knowledge, skills, and attitudes that should be expected of all family practice residency graduates; developed a list of basic, required educational resources for each family practice residency program; and proposed solutions to common obstacles to successful curriculum development.     

Career choices of general preventive medicine residency graduates: 1981-1986

To identify career choices made by recent graduates of general preventive medicine residency programs, all funded residency programs in general preventive medicine (excluding federal and military programs) were surveyed. Eighty-two percent of programs responded and reported on the career choices of 241 graduates who graduated from 1981 to 1986. In order of preference, the categories of career choice were: program activities (36.5%), teaching (19.1%), clinical services (17.0%), and research (6.2%). About one-fifth (21.2%) chose other activities. The number of graduates more than doubled between the periods 1981-1983 and 1984-1986. There was a threefold increase in the percentage of graduates involved primarily in research; however, there was a 33% decrease in the percentage of graduates who became professional academicians.     

Hospital privileges for family physicians. Patterns of recent residency graduates, residency director perceptions, and resident expectations

A national mail survey was performed that examined reports of recent residency graduates about hospital privileges for family physicians, perceptions of residency program directors about the percentage of their graduates who obtain privileges, and plans of third-year residents for seeking privileges. Privileges in medicine, pediatrics, surgery, obstetrics, and coronary care/intensive care units (CCU/ICU) were examined. Questionnaires were mailed to a random sample of 308 residency graduates aged 30 to 35 years, all 383 family practice residency directors, and a random sample of 319 third-year residents. Two mailings produced an 82 percent response rate. Most recent graduates had privileges in medicine (97 percent), pediatrics (95 percent), and CCU/ICU (87 percent). A majority (64 percent) had obstetric privileges, and a minority (36 percent) had surgical privileges. Directors were accurate in their perceptions of privileges attained by graduates in medicine, pediatrics, and CCU/ICU, but underestimated the percentage who had privileges in surgery and overestimated the percentage who had privileges in obstetrics. Residents planned on seeking privileges in medicine, pediatrics, and obstetrics at a rate similar to recent graduates, with lower percentages planning on seeking them in surgery and CCU/ICU. Privileges in surgery and obstetrics were more prevalent in the Midwest and West.     

The effect of federal grants on medical schools' production of primary care physicians.

OBJECTIVES. Title VII of the Health Professions Educational Assistance Act of 1976 was created to encourage the production of primary care physicians. This study explored recent trends in the proportion of US medical school graduates entering primary care in relationship to Title VII funding. METHODS. The American Medical Association Physician Masterfile was used to determine the specialty choice of all students graduating from American medical schools between 1960 and 1985. RESULTS. The proportion of graduates entering primary care rose from 19.7% in 1967 to 31.1% in 1976 and remained stable for the subsequent decade. The increase occurred before implementation of Title VII. Rural, state-owned medical schools with departments of family medicine tend to produce a greater proportion of primary care physicians than urban private schools without family medicine departments. CONCLUSIONS. The values of American medical schools and the reward structure of American medical practice favor the production of specialists over primary care physicians. Although Title VII helped to encourage and sustain the development of primary care educational programs at both the medical student and graduate levels, an increase in the proportion of primary care physicians will require fundamental changes.     

Experiences with a combined residency in internal and preventive medicine

BACKGROUND: The importance of integrating preventive medicine training into other residency programs was reinforced recently by the residency review committee for preventive medicine. Griffin Hospital in Derby CT has offered a 4-year integrated internal medicine and preventive medicine residency program since 1997. This article reports the outcomes of that program. METHODS: Data were collected from surveys of program graduates and the American Boards of Internal and Preventive Medicine in 2005-2007, and analyzed in 2007-2008. Graduates rated the program in regard to job preparation, the ease of transition to employment, the value of skills learned, the perceived quality of board preparation, and the quality of the program overall. Graduates rated themselves on core competencies set by the Accreditation Committee for Graduate Medical Education. RESULTS: Since 1997, the program has enrolled 22 residents. Residents and graduates contribute significantly toward quality of care at the hospital. Graduates take and pass at high rates the boards for both for internal and preventive medicine: 100% took internal medicine boards, 90% of them passed; 63% took preventive medicine boards, 100% of them passed). The program has recruited residents mainly through the match. Graduates rated most elements of the program highly. They felt well-prepared for their postgraduation jobs; most respondents reported routinely using preventive medicine skills learned during residency. Graduates either have gone into academic medicine (31%); public health (14%); clinical fellowships (18%); or primary care (9%); or they combine elements of clinical medicine and public health (28%). CONCLUSIONS: Integrating preventive medicine training into clinical residency programs may be an efficient, viable, and cost-effective way of creating more medical specialists with population-medicine skills.     

Residency Training in Preventive Medicine

In responding to questionnaires, directors of 37 of the 49 approved residency programs in preventive medicine (excluding aerospace medicine) reported that 285 physicians had entered such training in the academic years, 1960 to 1968. Of these, 92% proceeded into the second year, but only 45% continued into the third. Gainful employment, military service, and residency programs in other specialties were major avenues of loss. The chief difficulty in recruitment appeared to be lack of teaching and indoctrination in preventive medicine during medical school. The greatest monetary difficulties were related to instability of governmental funding and the fact that residents in preventive medicine usually do not fulfill a “service function” in academic settings. A significant number of full-time faculty positions in departments of preventive medicine are vacant. Respondents provided a number of suggestions for improvement.     

Success strategies for departments of family medicine.

Strong departments of family medicine in academic medical centers help assure the future scope and quality of family practice patient care, the ongoing evolution of family medicine as a scholarly discipline, and a continued flow of qualified medical school graduates into family practice residency programs and eventually into practice. This report presents key strategies of six successful departments of family medicine and describes the methods and skills considered important by the leaders of these departments. Common themes that emerge are (1) recruit and mentor the best faculty, (2) build a reputation for clinical excellence of faculty and residents, (3) become part of schoolwide curriculum activities, (4) establish a scholarly presence, and (5) develop networks of support.     

Practice location as a function of medical school and residency location: implications for resident selection

Numerous studies have documented an association between the state in which a physician practices and prior education in that state. To determine whether this relationship exists for recent family practice residency graduates, 95 randomly selected programs in which residents completed training in 1979 were surveyed to obtain information regarding practice location and medical school location for their graduates. Seventy-nine percent of physicians completing residency and medical school in the same state also practiced in that state. Of those completing residency in a state other than that of their medical school, 43 percent stayed in the state of their residency to practice, and 22 percent returned to the state of their medical school. An analysis of the impact that a policy restricting house staff positions to in-state students would have on physician supply for the state reveals that only about 10 percent more physicians would be expected to start practice in a state if such a policy were implemented.     

Using financial incentives to attract medical residents to the periphery: The Israeli experience

Background

In 2011, Israel instituted financial incentives as part of a larger program to attract doctors to residency programs in peripheral hospitals.

Relationship between US medical school admission policy and graduates entering family practice

Rural areas in the United States continue to lack an adequate supply of primary care doctors, particularly family physicians, despite the oversupply of physicians nationally. Previous studies have provided strong evidence that students from rural backgrounds, as well as those who expressed an interest at the time of medical school admission for a career in family medicine, are significantly more likely to eventually practise family medicine in rural areas than their peers. US medical schools were classified into three groups based on their written selection factors for preferentially admitting students into the graduating class of 1982. Of those schools with selection factors for students from both a rural background and an interest in a future career in family medicine, 23.7% of their graduates entered family medicine training programmes. This compares with 14.5% of graduates from schools with a preference for students from a rural background, and 12.4% from all other schools (P less than 0.001). Coupled with previous data which shows that family physicians from rural areas are more likely to eventually practise in rural areas than their peers, preferentially admitting students from rural backgrounds interested in a career in family medicine could help to solve the problem of the shortage of primary care physicians in rural areas in the US.     

Medical students' improved attitudes toward prevention of cardiovascular diseases from entry to graduation. Preventive Cardiology Academic Cooperative Research Group of the National Heart, Lung, and Blood Institute.

First-year medical students have been previously reported to have positive attitudes about disease prevention, in general, and about cardiovascular disease prevention, in particular. Whether medical school experiences exert a positive, negative, or neutral effect on prevention-oriented attitudes in medical students is not known. We assessed attitudes toward heart disease prevention in 770 entering medical students enrolled at six selected American medical schools, each having some curricular emphasis on preventive cardiology, and repeated the attitude survey near graduation in the 750 fourth-year students enrolled in the six schools. Response rates were similar at each of the schools for each administration and averaged 88% in entering students and 74% in the graduating students. We used two mean attitude scores, ranging from 1.0 to 5.0 on a Likert scale, 5.0 representing the most positive attitude. The score treating the importance of primary prevention increased from 4.08 +/- 0.39 to 4.35 +/- 0.41. The attitude score concerning the importance of research in preventive cardiology also increased from 3.65 +/- 0.56 to 3.90 +/- 0.64 (P less than .0001 for both comparisons of first-year to fourth-year students). Analyses by school revealed similar increases, as did analyses for men, women, whites, and nonwhites. The results indicate that positive attitudes toward heart disease prevention can become even more positive during medical school. The perpetuation of positive attitudes should contribute to improved clinical prevention behaviors when these graduates embark on careers in medicine.