Author Affiliations: Division of Graduate Medical Education, American Medical Association, Chicago, Ill.
Context By selecting a specialty to train in, physicians entering graduate medical
education (GME) training provide advance information about the future physician
Objective To determine trends in the residency choices of medical school graduates
entering GME training.
Design, Setting, and Participants The American Medical Association and Association of American Medical
Colleges jointly surveyed active programs as well as combined programs in
academic year 2002-2003 about active, transferred, and graduated residents.
In 2002 the survey was sent to 8064 program directors; 84.2% of them confirmed
the status of all active residents and 82.6% completed the program survey.
Main Outcome Measures In addition to overall trends, the specialty choices of graduates of
osteopathic schools (DOs) and international medical graduates (IMGs). Also,
where native US citizen resident physicians attended medical school if not
in the United States, with a focus on Hispanic ethnicity and Spanish-language
Results The census counted 98 258 resident physicians in GME programs in
academic year 2002-2003, similar to 5 years ago and reversing a decline over
the past few years. There were 23 443 residents in graduate year 1 (GY1)
positions, for which prior GME training is not required, a slight increase
from 2001-2002. The proportion of GY1 residents without prior GME increased
slightly compared with 2001-2002 (92.3% to 93.3%). In 1996-1997, 624 DOs were
GY1 residents without prior GME (2.9%); their numbers increased to 1312 (6.0%)
in 2002-2003. The number of IMGs in GY1 positions without prior GME also increased
over this period, from 5033 (23.5%) to 5623 (25.7%). Over the past 6 years
the number of IMG and DO GY1 residents without prior GME in specialties such
as general surgery, obstetrics and gynecology, and emergency medicine has
increased disproportionately faster than the overall rate. Hispanic native
US citizens are more likely to be IMGs than non-Hispanic native US citizens
(9.6% vs 5.0%). One third of Hispanic native US citizen IMGs received their
medical education in Spanish vs less than 3% of non-Hispanic native US citizen
Conclusions Nearly 25% of physicians in US allopathic training programs in 2002-2003
were IMGs, and the percentage of DOs continues to increase. The number of
residents conversant in Spanish could serve a need for a large US minority
Brotherton SE, Rockey PH, Etzel SI. US Graduate Medical Education, 2002-2003. JAMA. 2003;290(9):1197-1202. doi:10.1001/jama.290.9.1197