In this episode, we do a deep dive into the numbers of the Family Medicine Match. How many spots are there, how many unfilled, and so much more.
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[02:35] Match Summary
Data here is taken from the 2017 NRMP Residency Match Data. As far as number of positions offered, internal medicine is huge at over 7,233. Family medicine is the second largest and half as big, with 3,356 positions offered. Table 1 shows that 520 programs, more than internal medicine, but half the spots. So although it has more programs, it’s half the spots. Hence, the programs are much smaller.
Interestingly, there were 67 unfilled programs. This means people were not applying to family medicine. While there are so many that are applying to internal medicine. This is probably because of the fellowship training that you do after internal medicine. Which means you can go to Cardiology or do GI, or do Pulmonology or Rheumatology. You can do a lot of different subspecialties after Endocrinology, after Internal Medicine. So even the International Medical Graduates (IMGs) want that opportunity.
So out of 3,356 positions offered for Family Medicine, 1,797 U.S. Seniors applied fro those positions. Now, there were 6,030 total applicants for those 3,356 spots. Comparing this with internal medicine, they have over 7,000 spots and almost 12,000 students applying for those spots.
Just by numbers, you have more people applying for those Family Medicine spots than you do for internal medicine.
[06:35] Matches by Specialty and Applicant Type
Out of 3,356 positions, there are 3,215 filled positions and there were 141 spots that were left open. Of those, 1,513 were U.S Seniors, 132 were U.S. graduates – students who graduated from an MD medical school who may have taken a gap year to do research or travel. Or maybe they didn’t get in the first time. There are 574 osteopathic students so a lot of them are going into family medicine.
Interestingly, there’s a similar increase in osteopathic students going into internal medicine but there’s only 690 of them. Nevertheless, this means there’s a big opportunity for osteopathic students in family medicine. There’s one Canadian and 658 U.S.-citizen international medical graduates, and 337 non-U.S. citizen international medical graduates. This is a huge discrepancy here with foreign grads applying to internal medicine at a way higher number than family medicine. There were over 2,003 non-U.S. citizen international medical graduates applying for internal medicine and getting into internal medicine, and only 337 in family medicine. And I really think it’s that fellowship piece – just a wild guess!
[08:40] Growth Trends (2013-2017)
Table 3 shows the increase in size from 2013 to 2017. Family medicine has gone up 11.5% every year over this four-year period. It’s growing so it’s a much needed primary care specialty.
Moving down to Table 8 is positions offered and percent filled by U.S. Seniors and all applicants from 2013 to 2017. Again, not a lot of U.S. Seniors are applying to family medicine. Out 3,356 positions offered, 45.1% of those spots filled were by U.S. Seniors. Internal medicine is lower at 44.9%. Shockingly, Pathology is way lower at 35.9% filled up U.S. Seniors. This suggests that U.S. Seniors are not going into Pathology, and in fact, it’s getting less and less. In 2013, for Family Medicine, it’s 44.6%, then 45% (2014), 44% (2015), 45.3% (2016), and 45.1% for 2017.
Table 9 shows how big Family Medicine is compared to all other specialties. Internal medicine is the largest specialty for students matching every year, specifically at 25.6% in 2017. The second largest is Family Medicine at 11.6%. This is followed by Pediatrics at 9.7%, another big primary care specialty.
[10:48] PGY-1: U.S. Seniors and Osteopathic Students, Matched and Unmatched, and SOAP
Table 10 shows the U.S. Seniors matching into PGY-1 positions. The numbers don’t hold up here for U.S. Seniors though compared to all applicants. Internal Medicine has 18.6%,s still the largest. But Family Medicine here is not the second largest and only falls third or fourth at 8.7%. Emergency Medicine is larger with 9.2%.
Osteopathic students (Table 11) keep the trend going with 23.5% of students matching into an allopathic Internal Medicine program, while 19.6% matched into Family Medicine. When you look at the previous number of all applicants, 11.6% of all applicants matched into Family Medicine but 23.5% of osteopathic students matched into Family Medicine.
Figure 6 shows the percentages of unmatched U.S. Seniors and independent applicants. Family medicine and overall total unmatched of 25.3%, which is the fifth highest. The highest is Internal Medicine Prelim at 37% total unmatched. Second is Dermatology at 33.8%. Followed by Psychiatry at 30.8%, and then PM&R at 27.5% and fifth is Family Medicine. It has a high overall unmatched rate which is surprising considering there were so many programs that went unfilled.
Independent applicants are the majority of those unmatched with 40.9% and U.S. Seniors are pretty low at 3.5% unmatched.
Table 18 shows the SOAP (Supplemental Offer and Acceptance Program). These is offered for programs with MD spots that need to be filled. Family medicine had 67 programs that went unfilled and 141 spots. All of those programs participated in the SOAP. 64 programs filled and there were 3 spots at 3 programs that went unfilled.
[14:05] Charting the Outcomes 2016
Table FM-1 shows a summary of all the data for U.S. Allopathic Seniors. Mean number of contiguous ranks means that those who matched ranked 10.7 programs on average. This means that those who matched ranked a lot of programs. And those that did not match only ranked 4.5 programs. So they were much more strict with the programs they ranked and that hurt them.
The mean USMLE Step 1 Score is 221 and the average is around 230 for this data. So it’s a much lower score than average. Those that did not match was 208. So they’re struggling with their USMLE score. With that low score, they probably didn’t get interviews. And because they didn’t get interviews, maybe they didn’t rank the programs. So it’s not an issue with being too strict with the programs they’re ranking but it could just be an issue with their Step 1 score. Hence, they’re not getting interviews in order to be matched to rank.
Mean USMLE Step 2 score is 237 for those that matched and 223 for those who didn’t. Research experience is about the same at 2 and 1.7. Mean number of abstracts, presentations, and publications are the same at 2.6.
AOA members are 6.1% for those that matched and 0 for those who didn’t. It doesn’t mean though that you have to have AOA. It just means that the people didn’t match didn’t have it.
[16:38] Happiness, Burnout, and Compensation
Now, let’s look into the 2018 Medscape Physician Lifestyle and Happiness Report. In terms of happiness, 30% of physicians are very happy, outside of work is 12%, and extremely happy at 26%. As to who is the happiest, Family Medicine is in the lower half at 51%, within the range of 40%-61%.
As to which physicians are most introverted, Public Health and Preventive Medicine doctors are the highest at 48%. Family medicine is near the bottom at 37%. Radiology was at the lowest at 36%.
As to which physicians say they have three or fewer close friends, Family Medicine is near the top at 53%, Pathology is the highest at 58%. So this does not do any justice to Pathology and the stereotypes that come with Pathologists.
Looking at the 2018 Medscape National Physician Burnout and Depression Report, which physicians are most burned out, Family Medicine is near the top at 47%. Critical care is 48%. Neurology is 48%. There are a lot of specialties above 40%. The lowest is Plastic Surgery at 32%, along with Dermatology.
As to which physicians experience both depression and burnout, Family Medicine is still near the top of the list at 16%. OB GYN is the highest at 20%. As to which physicians are more likely to seek professional help, Family Medicine is again near the top of the list at 31%. Psychiatry is at 40%.
Moving on to the 2017 Medscape Physician Compensation Report, Family Medicine being a primary care specialty is right near the bottom at $209K a year. Just to compare it, the highest paid specialty is Orthopedics at $489K, more than double that of a family medicine doc, while Pediatrics is the lowest at $202K.
As to which physicians feel fairly compensated, even though Family Medicine is near the bottom of the list for compensation, they’re up near the top half for feeling fairly compensated at 53%. Emergency medicine doctors are the highest at 68%.
Would a family medicine doctor choose medicine again? They’re near the bottom half at 77%. The highest is Rheumatology is 83% and Neurology is the lowest at 71%. Which physicians would choose the same specialty? Interestingly, Family Medicine ranks second from the bottom at 67%. Internal medicine is the lowest at 64%.
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