Wednesday Mar 14, 2012

As Match Day Nears, Student Board Member Shares Wishes for Family Medicine

Of all the milestones in a physician's life, Match Day ranks highly among them. On March 16, more than 15,000 U.S. medical students will collectively tear open the envelopes that hold the key to their next steps in training.

Even more exciting about this Match Day is the potential for continued increases in U.S. seniors filling family medicine residency positions. Last year's Match saw an increase from 7.9 percent to 8.4 percent of U.S. seniors who chose family medicine. Anecdotal evidence from around the country says we're on target for another increase. Programs are reporting unprecedented numbers of applicants for first-year positions. Many had to offer additional interview days or expand the size of their interview class to accommodate the increased interest.

These numbers are on par with the growth we're seeing at the AAFP. The Academy has more than 17,000 student members. Students also are the fastest growing segment of membership. One in every four medical students is now a member of the AAFP.

More importantly, the quality of applicants is also reported to be more impressive than ever before. Academic achievements, leadership commitments, and community service pack the resumes of today's medical students. And they are choosing family medicine. The students I met on the interview trail were talented and compassionate -- these are your future family physicians.

Students also are being drawn to residency programs with "innovative curricula." Although this is a broad category, there have been so many training advances in recent years that there is something to appeal to every application. The P4 Program (Preparing the Physician for Personal Practice) set the stage by implementing and rigorously evaluating curricular innovations. The data from this initiative (sponsored in part by AAFP subsidiary TransforMED) is incredibly promising -- all of these programs have completely filled their intern classes in the past two years. Students are drawn to patient-centered medical home principles, electronic health record capabilities, fourth-year training opportunities, and longitudinal integrated learning.

Today's trainees desire more flexibility in their education to ensure they are trained with the medical knowledge, practice skills and systems-based perspective that will be required in future practice. Family medicine is leading the change.

Unfortunately, with all the growth we have seen in recent years, we still lag far behind the 40 percent family physician workforce recommended by the latest COGME report for ideal health outcomes. The lifetime income gap between primary care physicians and subspecialists -- estimated at $3.5 million -- is a major driver of inadequate numbers. Lifestyle considerations and eroding scope of practice fall a close second. On these fronts, too, the AAFP's advocacy efforts are making headway to both improve the practice environment and to attract the students needed to fill extra workforce demands.

I chose family medicine for many reasons, but most of all because I value the relationships I will one day form with my patients. Although many of the recent curricular and practice changes will never replace our commitments to our patients, they do supplement our ability to provide comprehensive and patient-centered care.

I eagerly await this Friday, when the next step in my path will be made clear. I have every hope that the 2012 Match will be another year of growing success for family medicine.

Jessica Johnson, the student member of the AAFP Board of Directors, is a student at the University of Connecticut School of Medicine, Farmington.

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