US graduate medical education, 2003-2004

Context Information about recent graduates of medical schools and the characteristics of physicians training in graduate medical education (GME) portends the size and composition of the US physician workforce of the near future. Objectives To examine trends in training programs and career choices of graduating male and female residents and to monitor trends in the size of the entire residency population. Design, Setting, and Participants The American Medical Association and Association of American Medical Colleges jointly surveyed residency programs during the academic year 2003-2004 about active, transferred, and graduated residents, as well as about program characteristics. The 8192 programs confirmed the status of 94.6% of residents. Nearly 86% of program directors (n=7040) completed the accompanying program survey. Main Outcome Measures Overall trends during the last 6 years in the number and characteristics of residents and programs, as well as the specialty of male and female graduating residents. Results There were 99964 active residents during the 2003-2004 academic year, the highest ever recorded by the National GME Census. The number of residents (n=22444) entering US graduate medical education programs for the first time is also the highest on record. In 1999, 28773 physicians completed training, 10546 (36.7%) of whom were women. In 2003, there were 29745 graduates, 11681 (39.3%) of whom were women, representing a 10.8% increase. The number of obstetrics/gynecology male graduates decreased 31.3%, while female graduates increased 18.2%. Other specialties that lost men and gained women were dermatology, family medicine, internal medicine, ophthalmology, pathology, psychiatry, and general surgery. The proportion of graduates who pursued additional training increased; percentages were 27.2% in 1999, 29.6% in 2001, and 32.1% in 2003. In 2000, 35.7% of programs provided opportunities to develop cultural competence; the percentage in 2003 was 50.7%. The percentage of programs with complementary/alternative medicine curriculum has held steady at 24%. Conclusions The number of physicians in GME is at its highest, and nearly one third of physicians completing training in one program continue on in another. The choices of female residents parallel those of male residents in many respects, but there are important differences.