Placement of U.S. Medical School Graduates Into Graduate Medical Education Remains Stable

The percentage of U.S. M.D. graduates entering graduate medical education (GME) the year of graduation has remained stable during the past decade despite an increase in the number of graduates, according to a study in the December 8 issue of JAMA, a theme issue on medical education.
Medical school enrollment has increased in the United States during the past decade; however, growth in GME positions has been slower, raising concerns about whether graduates will be able to obtain the GME necessary to qualify to practice medicine. Particular concerns have been raised about graduates from minority groups traditionally underrepresented in medicine. Henry M. Sondheimer, M.D., of the Association of American Medical Colleges, Washington, D.C., and colleagues evaluated graduates of all U.S. M.D.-granting medical schools from 2005 through 2015 to determine whether they entered GME training in the United States. The researchers reviewed the Association of American Medical Colleges Student Record System to identify all graduates. To identify those unplaced in GME upon medical school graduation who ultimately entered GME, the GMETrack First Year On-Duty file was searched in September 2015 for the years 2004 through 2014.
There were 186,937 graduates (48 percent female) during the study period, increasing from 15,762 in 2004-2005 to 18,705 in 2014-2015. The percentage of graduates unplaced in GME during the academic year of their graduation from medical school remained stable, ranging from 2.6 percent to 3.5 percent with an average of 3 percent. Unplaced black, Hispanic, and non-US citizen graduates increased over time. Racial/ethnic minority graduates were consistently less likely to begin GME the year they graduated than whites. However, within 6 years after graduation, more than 99 percent of all graduates entered GME or were found in practice in the United States. The racial/ethnic differences seen at graduation diminished with time but remained statistically significant.
“As the number of U.S. M.D. graduates continues to increase with the creation of new medical schools and the growth of existing schools, these trends should be closely monitored,” the authors write.