Too few medical school grads choose family medicine

Medical schools are “underproducing” family physicians, according to a new survey, though some states and regions seem to have more success with graduates choosing to go into primary care.

The study from the American Academy of Family Physicians and published in the October issue of Family Medicine examined all residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) to find the percentage of graduates from MD- and DO-granting medical schools who entered family medicine residency programs as first-year residents in 2015-2016.

According to the study, in 2015, 3,594 medical school graduates entered ACGME-accredited family medicine residency programs as first-year residents. Nearly half (48 percent) came from MD-granting schools, with another 29 percent being international students and 23 percent coming from DO-granting schools.

A greater percentage of students at those DO-granting schools, however, chose family medicine.

"There are four times as many MD-granting medical schools (134) as DO-granting medical schools (32)," the study said, and yet "they produce only 3.5 times as many total graduates compared to the DO-granting schools."

For MD-granting schools, the University of Minnesota produced the most family medicine residents with 42 graduates choosing the specialty. For DO-granting schools, Des Moines University College of Osteopathic Medicine in Iowa had the most graduates (68) and the largest percentage of graduates (32.7 percent) entering family medicine.

Location appeared to matter for family physicians. While schools east of the Mississippi River have more than double the number of total graduates than schools west of the Mississippi, and had 370 more graduates who went into family medicine, those western schools had a higher rate of family medicine residents (10.8 percent to 7.7 percent).

This was the first year the study specifically looked at family medicine residencies state-by-state, with the goal of “sparking curiosity at a local level” to inform policies that would encourage more doctors to enter primary care. The study’s conclusion was medical schools have continued to produce fewer family physicians than needed.

“The percentage of graduates of MD-granting medical schools entering ACGME-accredited family medicine programs has remained statistically unchanged over the last decade, as has the total number of family medicine positions available,” the study said. “Against the backdrop of population growth and aging, as well as growth in the number of insured Americans, a stagnant primary care workforce has exacerbated—and will continue to if nothing changes—the shortage of primary care in the United States.”