Family medicine and hospital specialty match rates: does the economy have anything to do with it?

Abstract

OBJECTIVE: This study explored whether certain economic markers are associated with changes in the selection of primary care as a career. METHODS: Using linear regression models, we examined whether economic factors in the United States could be used to predict the variability in US senior match rates in family medicine and three hospital-based specialties between 1978 and 2000. RESULTS: A linear regression model using several economic indicators showed that public and private expenditures were associated with the US senior match rates in family medicine, anesthesia, and radiology. As private expenditures increased, the match rate for family medicine fell while the match rates for anesthesia and radiology increased. Increases in public expenditures were associated with increased family medicine match rates and declining match rates for the other two specialties. Increases in private spending resulted in average increases of 0.92% and 2.38% in the anesthesia and radiology match, respectively, with a drop in family medicine match rates of 1.36%. We found that for every 1% increase in public expenditures for health, family medicine match rates rise on average 1.39%, while anesthesia rates fall by 0.84% and radiology rates drop 2.16%. CONCLUSIONS: The amount of public and private funding for health care is associated with US senior match rates in family medicine, anesthesia, and radiology. Changes in these funding sources may predict future student specialty choice and could be used to plan residency match rates in disciplines such as family medicine.