Match Day: More medical graduates entering primary care

Janice Lloyd, USA TODAY | USATODAY

The number of medical students committing to primary care rather than specialties increased for the fourth straight year in the largest "match program'' in history, a report out Friday says, but medical experts warn a severe shortage of doctors will still exist.

The numbers were announced as part of the Match Day event in which graduating medical school seniors find out where they will spend their residencies -- the next three to seven years of their medical careers.

About one-quarter (11,762) of the applicants matched to resident positions that train doctors to be on the front line of care — in the areas of internal medicine, pediatrics and family medicine — where serious shortages exist. These physicians diagnose physical illnesses, manage chronic ones, teach prevention and detect mental illnesses. Though more physicians will be needed in all fields, a shortfall of 9,000 primary care doctors as of 2010 will soar to 65,000 by 2025.

This year's primary care gains are modest — 1,502 more positions than in 2012 — but the increase shows the "health care overhaul is putting more emphasis on the need for these kinds of doctors," says Jeff Cain, president of the American Academy of Family Physicians. "We welcome this news and expect the trend to continue."

U.S. students filled only about 50% of the primary care jobs, which typically pay less than specialties and also have longer work hours.

Cain says the percentage of doctors in primary care is about "32%, and we hope to see that grow to 40% to 50%." Additional doctors will be required to keep up with the nation's rapidly aging population, which "has more chronic conditions requiring more time for doctors to treat," he says, and the 48.6 million uninsured Americans who will join the ranks of the insured in 2014 when the government health care program expands.

A total of 29,141 positions were offered, 4,000 more than in 2009 — a year before health care change was voted into law. Almost 1,000 more U.S. seniors participated this year, and more than half matched to their first choice. Students might match to more than one program.

Hundreds of other U.S. seniors "did not match and will not begin residencies programs this summer and maybe not in the future,'' says Darrell Kirch, president of the Association of American Medical Colleges. "Congress has refused the funding of new residencies. We have called for an increase of 30% more doctors being trained in our schools, but they can't all find residencies."

Three new U.S. medical schools graduated their first seniors. An additional 2,399 positions were offered in all areas of medicine, says Mona Signer, executive director of the National Resident Matching Program, the group responsible for aligning students with programs. Kirch says those new positions were pulled in from other training programs that already existed.

Among the 2,399 new positions, 1,438 were offered in primary care: 141 to pediatrics, 1,000 to internal medicine and 297 to family medicine.

"The significant increase in positions was due to a change in policy that requires match-participating programs to register and attempt to fill all positions in the match,'' Signer says.

Emergency medicine offered 1,744 positions, 76 more than last year.

Students will spend the next three to seven years training in the programs. In addition to students from U.S. medical schools, the match included:

2,677 students and graduates of osteopathic schools, an increase of 317 over 2012.

5,095 U.S. citizens graduating from international medical schools, 816 more than in 2012.

7,568 non-U.S. citizens students graduating from international medical schools, 740 more than 2012.

U.S. seniors filled 70% of the pediatric positions, while filling only 50% of the positions in family and internal medicine.