Match Day- Surgery remains most popular, primary care rising


Surgery residencies are still the top choice for U.S. medical students, but the number choosing primary care continues to rise.

The 2013 Match Day results show that dermatology, emergency medicine, medicine-pediatrics, neurological surgery, orthopedic surgery, otolaryngology, radiation oncology, general surgery, and plastic surgery are the top choices for medical students. Residency programs in these specialties filled at least 80% of their positions with U.S. seniors.

Nearly 400 more U.S. medical students chose primary care residencies in this year’s Main Residency Match than did in 2012, according to data from the National Resident Matching Program.

The number of U.S. medical students choosing residency positions in internal medicine, family medicine, and pediatrics all rose in 2013, with internal medicine getting the biggest boost. The number of U.S. seniors matching to internal medicine rose by 194, while pediatric matches with U.S. seniors increased by 105 and family medicine rose by 33.

The results point to an increased interest in primary care that has been percolating over the last few years.

Mona M. Signer, executive director of the National Resident Matching Program (NRMP), said the 2010 Affordable Care Act may be driving some of the interest.

"There is a lot of talk about the fact that the Affordable Care Act is going to create demand for more physicians, in particular more primary care physicians. Perhaps that is finally starting to resonate with U.S. seniors," Ms. Signer said in an interview.

With the Match program becoming more competitive, medical school seniors may also be getting more realistic about their matching chances. Ms. Signer said the NRMP produces a report called "Charting Outcomes in the Match" (2011 data) that shows the test scores, the number of research publications, and other characteristics of previous successful candidates for each specialty. Applicants and their medical school advisors are looking at the online report, she said, and getting savvier about the specialties in which they are most likely to be competitive.

In internal medicine, 6,277 positions were offered this year, an increase of 1,000 over 2012. Of those, 99.4% were filled, with 49.9% taken by U.S. medical graduates.

In 2013, 3,037 family medicine residency positions were offered. Of those, 95.9% were filled, with 44.6% filled by U.S. medical graduates.

In pediatrics, 99.6% of the total 2,616 positions offered were filled. U.S. medical graduates filled 70.2% of the pediatric positions.

Though the match rate for U.S. graduates stayed about the same in pediatrics this year as in 2012, it was down somewhat in internal medicine and family medicine. The reason, Ms. Signer said, is that there were just so many more positions offered in those specialties than in previous years.

This year marked the first Match held under the NRMP’s new "all-in" policy, which requires programs participating in the Match to register and attempt to fill all of their available positions within the Match. Previously, some programs had offered positions outside of the Match process and the NRMP board of directors concluded that the practice placed too much pressure on students to accept these positions rather than to take their chances in the Match. The practice of offering positions outside the Match primarily affected osteopathic students, prior-year graduates of U.S. allopathic schools, and international medical graduates, Ms. Signer said.

As a result of the all-in policy, there were 1,000 more internal medicine positions in the Match, 297 more family medicine positions, and 141 positions in pediatrics, according to NRMP.

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