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.     

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: 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 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: 2005-2006 and 3-year summary

This is the 25th 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 8.4% of the 16,066 graduates of US medical schools between July 2004 and June 2005 were first-year family medicine residents in 2005, compared with 9.2% in 2004 and 9.3% in 2003. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2005 than were residents from privately funded schools, 9.9% compared with 5.8%. The Mountain and the West North Central regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2005 at 13.3% and 12.7%, respectively; the New England and Middle Atlantic regions reported the lowest percentages at 5.2% and 5.6%, respectively. Nearly half of the medical school graduates (47.3%) entering a family medicine residency program as first-year residents in October 2005 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: 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: 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: 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.     

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.     

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.     

Characteristics of and Issues Faced by Rural Female Family Physicians

The purpose of this study was to identify characteristics of and issues faced by female family physicians practicing in rural areas. A 37-item survey was designed to obtain demographic information about the background, community and practice of rural female physicians. An open-ended question regarding the issues and problems faced by female physicians in rural communities was included. Study subjects were identified from the membership of the American Academy of Family Physicians (AAFP). The questionnaire was mailed to all 850 active female AAFP members practicing in communities with less than 50,000 inhabitants during the winter of 1999. Completed and usable surveys were received from 587 (69.9 percent). The average age of respondents was 45. The majority were married (81.1 percent) and had children (80.1 percent). Half of the women had grown up in communities of 25,000 or less population. Twenty-seven percent of the respondents had no rural exposure in medical school; 39 percent had no rural exposure in residency; and 16 percent had no rural exposure in medical school or residency. The majority of respondents (62 percent) practiced in communities of less than 10,000. A large majority (70 percent) of these women planned to stay in the community for 10 years or more, with 58.6 percent responding that they plan to stay indefinitely. Assumptions regarding rural physicians, especially women, must be updated to accurately assist communities in recruiting rural physicians and to assist medical schools and residencies in adequately preparing graduates for rural practice.     

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.     

Career preferences of graduate and non-graduate entrants to medical schools in the UK

OBJECTIVE: Recent UK policy has been to increase substantially the number of graduate entrants to medical schools. Our aim was to study whether graduate and non-graduate entrants have different long-term career preferences. METHODS: We conducted postal questionnaire surveys of medical qualifiers from all UK medical schools in 1999, 2000 and 2002, surveyed 1 year after qualification, and qualifiers of 1999 and 2000, surveyed 3 years after qualification. RESULTS: By Year 3 after qualification, general practice was the choice of 33% of men graduate entrants and 21% of men non-graduates ( = 12.5, P < 0.001) and of 43% of women graduates and 38% of women non-graduates ( = 1.6, P = 0.2). Surgery was a much less popular choice for men graduate entrants than for men non-graduates; but similar percentages of women graduate and non-graduate entrants chose surgery. A lower percentage of graduate entrants than of non-graduates favoured paediatrics. Other differences between graduates and non-graduates were generally small. General practice was the preferred career for a much lower percentage of those who took an intercalated degree while at medical school, than of those who did not. CONCLUSIONS: Increasing graduate entry to medical school is likely to increase the percentage of doctors who want to become general practitioners, but only modestly so. It may also lead to a decline in the percentages choosing surgery and paediatrics. Otherwise, at least on the current criteria used for selecting students, increasing graduate entry will probably not make much difference to the percentage of newly qualified doctors seeking careers in different branches of practice.     

Physicians for Rural America: The Role of Institutional Commitment Within Academic Medical Centers

CONTEXT: Prior study suggests that contextual characteristics of medical schools (e.g., state demographics, public vs private, NIH research effort) predict output of rural physicians without also considering the effects of the medical schools' own policies and programs. PURPOSE: This study examines medical school commitment to rural policies and programs and its relationship to contextual characteristics and rural physician output. METHODS: A survey of 122 U.S. allopathic medical schools provided data to construct a 32-item Rural Commitment Index for each medical school. Data for other characteristics were linked from published sources. Correlations, t tests, and multiple regression analysis were used to study the association between variables and percentage of medical school graduates (1988-1996) who were in rural primary care practice in 2000. FINDINGS: Among 90 medical schools (response rate, 73.8%), the Rural Commitment Index correlated with the percentage of the state population that is rural and whether the school is public or private, and it joined percentage state population rural, public vs private, and National Institutes of Health support in correlating with percentage of graduates in rural primary care. In a regression model that explained 48.4% of variation in the percentage of graduates in rural primary care, the Rural Commitment Index explained most variation, followed by percentage state population rural, public vs private, National Institutes of Health support, and the interaction between the Rural Commitment Index and public vs private. CONCLUSIONS: The findings support the proposition that observable institutional commitment affects rural physician output and provide justification for a definitive study to verify that a change in medical school commitment to rural medicine produces a change in rural physician output.     

House call practices among young family physicians

Once a major part of medical practice, physician house calls have declined in frequency over the years. Recently, it has been suggested that house calls are increasing. This study examined the current self-reported house call practices among recent graduates of family practice residency programs in the United States. A questionnaire was mailed to a cross-sectional, random national sample of 301 family physicians who are members of the American Academy of Family Physicians and who completed a residency between 1981 and 1986. There was a 66% response rate to three mailings, with 197 questionnaires analyzed. Sixty-two percent of the physicians reported they were making house calls. The majority (53%) made less than one house call per month. Fewer than 15% made house calls on a weekly basis. There was a downward trend by residency year in the percentage of physicians making house calls when comparing graduates from 1981 to 1986. House calls do not appear to be a significant part of the practice of young family physicians.     

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.     

Family medicine residency training--three or four years?

Opinions about a four-year family practice residency were elicited from a nationally representative sample of three groups of family physicians. Questionnaires were mailed to a random sample of 308 residency graduates aged 30 to 35 years, all 383 residency directors, and a random sample of 319 third-year residents. Two mailings produced an 82 percent response rate. A four-year residency was favored by 32 percent of recent graduates, 20 percent of program directors, and 34 percent of third-year residents. Over 60 percent of residents and recent graduates would have entered a family practice program had the residency been of four years' duration. Perceived barriers to a four-year residency included lack of resources, loss of appeal, and the additional time commitment. Respondents were most willing to complete a fourth year of residency to receive additional training in orthopedics, obstetrics, gynecology, and pediatrics. Many respondents believed that the additional year would be helpful in obtaining hospital privileges in obstetrics and in coronary care and intensive care units. This study provides information useful in discussions regarding extending residency training.     

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.     

Individual and contextual factors related to family practice residents' assessment and counseling for tobacco cessation

BACKGROUND: Tobacco use is the chief avoidable cause of death in the United States. Physicians, however, are not routinely assessing this risk and providing counseling for risk reduction. This study examines tobacco cessation counseling practices among family practice residents and explores the determinants of residents' smoking-counseling behaviors and counseling duration. METHODS: One hundred ten family practice residents (response rate = 93.2%) from four Texas residency training programs completed a survey designed to assess tobacco cessation counseling practices. RESULTS: A high proportion of residents reported that they usually or always assessed tobacco use (59.3%) and advised their patients to quit smoking (80.9%), with a lower proportion reporting specific counseling behaviors (7.3% - 21.9%), referrals (1.8%), or follow-up visits (1.8%). Year of residency, perceived effectiveness, and the interaction between perceived effectiveness and residency year were significantly associated with number of counseling behaviors, and year of residency and perceived effectiveness were significantly associated with counseling duration. CONCLUSIONS: Faculty physicians should assist residents to implement the Public Health Service-sponsored clinical practice guideline for tobacco control. There is a need to increase behavioral skills and perceived effectiveness for assessing and counseling smokers among first-year residents.