By Aaron Michelfelder, MD; Joel Heidelbaugh, MD; Cristen Page, MD, MPH, and Eva Bading, MD
As matching into all specialties has become more challenging in the last few years for US medical students, it is important to provide the most timely and accurate advice to those considering family medicine.
Several confounding factors contribute to a more challenging match into family medicine as a primary specialty choice:
- Medical school class size has increased, and new schools have been formed without any increase in residency positions.
- There is an increase in US citizens who are international medical students and who are entering the residency Match pool.
- Medical specialties are becoming more competitive, and students at risk of not matching into their primary specialty choice are creating parallel plans.
- Fourth-year medical students apply to two or three different specialties, which results in more students applying to family medicine, many of whom are highly competitive and have high USMLE scores.
- Students who in the past would have been offered many interviews are being offered fewer due to the influx of parallel plan students flooding the family medicine applicant pool.
- Programs are placing a higher emphasis on USMLE scores as a method of predicting the possibility of passing the ABFM board exam.
- National Residency Matching Program All In Policy means that more residency slots are filled during the Match, and fewer are available for the Supplemental Offer and Acceptance Program, or SOAP (formerly called “the scramble”).
We recently hosted lecture-discussions on matching into family medicine at the 2014 Society of Teachers of Family Medicine Conference on Medical Student Education and the 2014 Association of Departments of Family Medicine Conference and have collated the thoughts and recommendations of these national discussion participants with advice to students wishing to match into family medicine as listed below.
1) Students should pass and perform well on USMLE Step 1 on the first attempt. It is better to delay clinical clerkships and graduation than to fail Step 1. Some residency programs use the average Step 1 score (around 220) as a cutoff for interview invitations.
2) Students should work hard and perform well on clinical clerkships. International medical students understand that performance on clerkships can help with getting a residency spot, so US medical students can sometimes be overshadowed by very capable and hard-working international medical students. US medical students are competing more than ever against many talented and competitive US and international medical graduates.