It's past time to reform the musculoskeletal curriculum.
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Biomedical subjects
Publications and source records attributed to D J Ostergaard.
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The 1998 National Resident Matching Program (NRMP) results reflect a change in the perceptions and choices of physicians entering graduate medical education in the United States. Ninety-one fewer positions were filled in family practice residency programs in 1998, as well as 21 fewer in primary care internal medicine, 12 fewer in primary care pediatrics, and 13 fewer in internal medicine-pediatric programs. In contrast, 49 more positions were filled in anesthesiology, and 12 more US seniors chose diagnostic radiology, two "marker" disciplines that have recently been market sensitive. Thirty-four more positions were also filled in each of categorical internal medicine and pediatrics programs, where trainees are "pluripotential" with perceived options for practicing as generalists or entering subspecialty fellowships, depending on the market. While the demands of managed care and the needs of rural and underserved populations continue to offer a market for family physicians, family practice may have experienced a "primary care backlash" though the 1998 NRMP.
The 1997 National Resident Matching Program (NRMP) results reveal all-time highs for the number of positions filled in family practice residencies (2,905) and the number of positions filled with US seniors (2,340). This is the largest number of US seniors choosing family practice in the history of the NRMP. Of the 65 additional positions filled through the NRMP, compared with 1996 (2,905 versus 2,840), 64 were filled with additional US seniors (2,340 versus 2,276). Continuing a trend begun in 1992, the 1997 results showed more positions filled in family practice residencies on July 1 than in the previous year, with 3,570 in 1997, compared with 3,494 in 1996. Internal medicine residencies matched 128 more US seniors in 1997, and pediatric residencies matched 63 more US seniors. Of the US seniors matching through the NRMP, only 37.5% are predicted to practice as generalists. In the past 5 years, family practice has been the choice of 71.5% of additional US seniors choosing primary care. The continued record increased interest in family practice as a career, coupled with the nation's need for more family physicians, demands increased support for the nation's family practice residency programs.
The results of the 1996 National Resident Matching Program (NRMP) set records in the number of positions filled in family practice residencies, with a 10.8% increase over 1995 (2,840 vs 2,563) and a 9.4% increase in positions filled with US seniors (2,276 vs 2,081). This is the largest number of US seniors choosing family practice in the history of the NRMP. A total of 196 (6.7%) more positions were offered in family practice through the NRMP, compared with 1995 (3,137 vs 2,941). Thus, 195 of these additional 196 positions were filled with US seniors. In keeping with the trend begun in 1992, 242 more positions were filled on July 1, 1996, than 1995 (3,494 vs 3,252), for a fill rate of 97.8%. Internal medicine residencies matched 67 fewer US seniors in 1996, while pediatric residencies matched 85 more US seniors. During the past 4 years, family practice has been the choice of 82.6% of the additional US seniors choosing a primary care residency. With continued record increased interest in family practice as a career choice and the need for more family physicians, priority support for the nation's family practice residency programs continues to be of critical importance.
The 1995 National Resident Matching Program (NRMP) results broke records in the number of positions filled in family practice residencies, with an increase of 11.8% over 1994 figures (2,563 vs 2,293) and an increase of 12.5% in positions filled with US seniors (2,081 vs 1,850). This is the largest number of US seniors choosing family practice in the NRMP's history. In keeping with the trend that began in 1992, 7% more positions were filled on July 1, 1995, than were filled at the same time in 1994 (3,252 vs 3,040). Internal medicine residencies matched 74 more US seniors in 1995, and pediatric residencies matched 84 more US seniors. Given the anticipated career choices of students entering residency training in the generalist disciplines (95% of students matching in family practice, 60% of students matching in pediatrics, and 45% of students matching in internal medicine), it is expected that 33.5% of the class of 1995 (Liaison Committee on Medical Education-accredited medical schools) will practice as generalists. First-year positions offered in family practice through the NRMP increased 6%, and the number of Accreditation Council on Graduate Medical Education-accredited family practice residency programs increased 3% (421 vs 410). With continued increased interest in family practice as a career choice and the need for more family physicians, support for the nation's family practice residency programs continues to be of critical importance.
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The 1994 National Resident Matching Program results reveal a 14% increase in positions filled in family practice residencies, compared with 1993 (2,293 vs 2,002) and a 13% increase in positions filled by US seniors (1,850 vs 1,636). Similarly, 9% more positions were filled on July 1, 1994, than 1993 (3,040 vs 2,798). For the first time, in 1994 more than 3,000 first-year residency positions were filled in family practice. One hundred more US seniors matched in internal medicine, and 74 more US seniors matched in pediatrics. Given the anticipated career choices of students entering residency training in the generalist disciplines, it is expected that 31% of the class of 1994 (Liaison Committee on Medical Education (LCME)-accredited medical schools) will practice as generalists. An 8% increase in first-year positions offered, and the development of 10% new Accreditation Council for Graduate Medical Education-accredited family practice residency programs could accommodate 20% of the nation's graduates of LCME- and American Osteopathic Association-accredited medical schools. With increasing interest in family practice careers, increased support for the nation's family practice residency programs is critical.
The 1993 NRMP results reveal a 19% increase in positions filled in family practice residencies compared to 1992 (2,002 versus 1,658) and a 17% increase in positions filled by US seniors (1,636 versus 1,398). Similarly, 11% more positions were filled on July 1, 1993, than 1992 (2,798 versus 2,530). This confirms a trend begun in 1992 of increased interest in careers in family practice, reversing four years of declining interest from 1988 to 1991. Two hundred one fewer US seniors matched in internal medicine, while 36 more chose pediatrics. Of students entering residency training in the generalist disciplines, it is expected that 27% of the class of 1993 (LCME-accredited medical schools) will practice as generalists. An increase of 9% of first-year positions offered, and the development of 15% new ACGME-accredited family practice residency programs, could accommodate 20% of the nation's graduates of LCME- and AOA-accredited medical schools. With increasing interest in careers in family practice, increased support for the nation's family practice residency programs is critical.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
After 4 years of declining fill rates through the National Resident Matching Program (NRMP), 74 more positions in family practice residencies were filled in 1992 than in 1991, including 24 more filled with US seniors. The March fill rate (67.5%) increased for the first time since 1987, while the July fill rate (90.7%) increased for the first time since 1984. The Mountain and Pacific regions had the highest fill rates (89.1% and 88.5%, respectively) through the NRMP. Community-based, unaffiliated and university-affiliated programs filled 71.0% and 70.3% of positions offered through the NRMP. University-based and community-based, university administered programs filled 63.8% and 61.0% of positions offered through the NRMP. The other commonly defined primary care specialties of internal medicine and pediatrics also filled increased numbers of positions offered through the NRMP. This is the first year since 1984 in which all three primary care specialties matched more positions than in the previous year. The demand for family physicians in the United States is increasing. Evidence presented here suggests that 1992 may mark the beginning of a new trend toward increased interest in careers in family practice.
BACKGROUND AND OBJECTIVES: The Residency Assistance Program (RAP) in family practice was established in 1975 to provide consultative assistance to family practice residency program directors interested in enhancing the quality of their training programs. Since its inception, RAP activities have been monitored and policies approved by a project board, with representation from all the national family medicine/practice organizations. The voluntary, confidential, nonpunitive, collaborative problem-solving process has provided more than 800 RAP consultations in RAP's 20 years of operation. This paper reviews the historical development, current status, and future directions of the program.