PROFESSIONAL ISSUES

School debt helps drive medical students into specialty matches

Family practice and internal medicine leaders said Match Day 2003 wasn't the best for primary care.

By Damon Adams, AMNews staff. April 7, 2003.

James C. Martin, MD, believes family physicians are the backbone of the health care system. But the San Antonio, Texas, doctor sees the spine weakening.

For the sixth year in a row, the number of graduating medical school seniors and other match applicants who chose residency programs in family medicine has dropped, according to the National Resident Matching Program.

This year's Match Day figures show that seniors are increasingly choosing residencies in specialties. Many are driven by better-paying job opportunities for specialists, income that will take a bigger bite out of their student debts.

Some primary care organizations are worried that the students' choices will translate to fewer family doctors and internists. Dr. Martin, president of the American Academy of Family Physicians, said the decline of family medicine residency matches eventually would devastate health care, and the trend needs to be reversed. "My concern is what is this going to mean for the health care system in this country."

Internal medicine leaders also saw discouraging signs in the 2003 Match Day numbers.

Although international medical graduates and others helped internal medicine matches increase over last year, U.S. seniors seeking internal medicine residencies dropped about 10% since 1999.

"Internal medicine doctors are unhappy people these days. They feel overregulated. They feel underappreciated. ... Students pick up on that," said Patrick Alguire, MD, director of education and career development for the American College of Physicians.

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