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Monday, March 20, 2023

Match Day for Med Students

Last Friday was "Match Day," when senior medical students learned whether they had matched with their preferred residency program. With over 43,000 applicants rank ordering programs, which in turn rank ordered the applications, the process generates plenty of data about the medical profession, given that today's residencies affect the distribution of physicians for decades to come.

According to MedPage, three of the most in-demand programs were in surgery -- orthopedic, plastic, and thoracic -- and the fourth was radiology. In contrast, the programs left with unfilled positions -- more openings than applicants -- were all forms of primary care, mostly those with frequent patient contact: family medicine, internal medicine, emergency medicine, pediatrics, and psychiatry. Not coincidentally, no doubt, those are also the lowest-paying specialties, even though they account for the most common patient interactions. This is not a good trend.

There is also some interestingly encouraging news. It appears that the Dobbs decision may have had an impact on med students' preferences. As reported in the Journal of General Internal Medicine:

In a survey of more than 2,000 current and future physicians on social media, we found that most (82.3%) would prefer to work or train in states with preserved abortion access. In fact, more than three-quarters (76.4%) of respondents would not even apply to states with legal consequences for providing abortion care. The same holds true for states with early or complete bans on abortion or Plan B. In other words, many qualified candidates would no longer even consider working or training in more than half of U.S. states.

[These] preferences persisted across medical specialties and subspecialties, underscoring the essential truth that abortion rights and access affect the entire physician workforce and, thus, the whole healthcare system.

While 77.8% of respondents report that their preferences are influenced by patient access to abortion care, others also prioritize preserved access for themselves or their partner (56.1%) or other family members (42.5%). This should not surprise us: physicians are human beings, too, with healthcare needsopens in a new tab or window and personal lives that are not wholly defined by their career choices.
Of course, it remains to be seen whether stated preferences will be reflected in actual choices. It is hard to imagine that many aspiring oncologists will turn down residencies at Houston's MD Anderson Cancer Center, for example, although they may still decide to practice elsewhere post-training. Dobbs was only decided last year, so the longer term effect on physician supply will take a while to develop.

Posted by Steve Lubet on March 20, 2023 at 10:00 AM | Permalink


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