Letters to the Editor
To the Editor:
In his May 2012 report, Jolly1 demonstrates that during academic year 2009–2010, 3,488 physicians obtained residency positions outside of the National Resident Matching Program’s Match and that, of the 25,432 residency positions available, there were 9,425 more such positions than the 16,007U.S. graduates of MD-granting schools during the period studied. The existence of these 9,425 positions, or 58.8% more than the number of U.S. seniors from MD-granting schools, essentially ensured that most of these seniors obtained their first choice of specialty even if not their first choice of residency program.
However, in 2020 it is anticipated that 21,376 students2 will graduate from U.S. MD-granting schools. Unless there is a significant increase in residency positions, the discrepancy between the number of those graduates and the total number of positions will be reduced to 3,624. That number is only one-sixth, or 16.9%, more than the anticipated number of graduates of MD-granting schools in 2020, versus 58.8% more in 2010. Of course, it is likely that U.S. medical graduates, from MD-granting schools or otherwise, will continue to be more competitive than international medical graduates in obtaining residency positions. The difference is that U.S. graduates, who today can overwhelmingly obtain their first choice of specialty, may have more difficulty doing so, which would significantly reduce their career options. This more constricted situation may have a negative impact on the morale of medical students and residents and may affect the future recruitment of physicians and, later on, how they practice medicine.
To counter the effects of these possibilities, we in academic medicine must present to premed students the broad discipline of medicine in a new light. The practice of medicine, not of a particular specialty, must be taught and seen as a unique human experience. We must highlight the knowledge and skill essential to being a physician and the responsibilities that go with it, no matter what the specialty. We must concurrently work to develop contemporary models of practice that ensure that individuals can use the special skills essential to being a physician and the opportunity to experience the responsibility, excitement, pleasure, and honor in caring for another human being.
Sidney H. Weissman, MD
Professor of clinical psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; firstname.lastname@example.org.
1. Jolly P.. First-year residents who began their graduate medical education in 2009–2010 and found their positions within and outside the NRMP Match. Acad Med.. 2012;87:586–591