Family / Emergency

There's more match-blogging from two surgeons, Aggravated DocSurg and
Cut-to-Cure, who've each pored over the results and make observations on the decline of family practice and rise of the specialties.

Kevin is also hosting a provocative discussion on the future of family practice, which grew out of an earlier post that I commented on, regarding efforts to foster continuity-of-care in medical education.

They're right to speculate about students choosing internal medicine or pediatrics over family medicine. Cut-to-Cure's Dr. Bard-Parker in particular wonders if the lack of fellowship opportunities make Family less attractive -- could students instead choose IM, and delay the decision between primary care or specialization? Very possible.

It also seems to me that Emergency medicine may be picking up some of the med students who, in the past, might've gone into Family practice. EM has the same broad diversity of presentations, but with training for resuscitation and a good number of procedures. (Family has procedures, too, but as Dr. Tony notes, these privileges vary from place to place.)

More from on the EM NRMP match from Louis Binder, in this month's ACEP News:

Emergency medicine was cited by the NRMP as one of the more competitive first-year residency positions, along with dermatology, general surgery, orthopedic surgery, and plastic surgery.

At least 95% of the available positions in these specialties were filled, with 80% or more filled by U.S. seniors, according to the NRMP's 2005 data.

"Emergency medicine is clearly in the growth stage, although at some point, you'll see a saturation of the numbers in medical schools," Louis Binder, M.D., associate residency director at MetroHealth Medical Center in Cleveland and professor of emergency medicine at Case Western Reserve University, told ACEP NEWS. "It's one of the top three competitive residencies."

"Competitive" is a loaded term -- it's hard to measure the aggregate selectivity of these programs, or the qualifications of the students, FMGs, and PGY-1's comprising this July's EM residents. But I think it's clear that EM residency is very desirable now.