Robert C. Bowman, M.D. Medical school graduates by class year and major specialties from the Masterfile 2005 version
2005 Masterfile |
1987 |
1988 |
1989 |
1990 |
1991 |
1992 |
1993 |
1994 |
1995 |
1996 |
1997 |
1998 |
Allergy Immunology |
79 |
68 |
73 |
61 |
67 |
42 |
32 |
44 |
41 |
56 |
73 |
87 |
Anesthesia |
1141 |
1135 |
1111 |
1220 |
1155 |
1090 |
836 |
664 |
443 |
316 |
421 |
535 |
Pain Management (anesth) |
36 |
34 |
44 |
76 |
67 |
65 |
83 |
67 |
49 |
26 |
27 |
39 |
Cardiology |
455 |
473 |
484 |
437 |
382 |
369 |
279 |
294 |
269 |
270 |
285 |
349 |
Diagnostic Radiology |
620 |
659 |
641 |
589 |
683 |
615 |
622 |
566 |
585 |
563 |
496 |
569 |
Emergency Medicine |
612 |
599 |
616 |
642 |
707 |
743 |
804 |
822 |
878 |
998 |
934 |
952 |
Endocrinology |
69 |
92 |
81 |
65 |
65 |
54 |
57 |
63 |
64 |
70 |
95 |
100 |
Family Medicine |
1847 |
1633 |
1633 |
1662 |
1667 |
1778 |
2010 |
2285 |
2484 |
2622 |
2636 |
2459 |
Gastroenterology |
274 |
303 |
288 |
290 |
244 |
217 |
153 |
134 |
168 |
165 |
191 |
241 |
General Surgery |
534 |
555 |
540 |
542 |
580 |
566 |
593 |
665 |
627 |
675 |
680 |
668 |
Infectious Disease |
132 |
155 |
131 |
138 |
110 |
117 |
112 |
121 |
130 |
136 |
137 |
136 |
Internal Medicine (general) |
1918 |
1828 |
1681 |
1678 |
1767 |
1961 |
2092 |
2072 |
2169 |
2079 |
1977 |
1929 |
Internal Medicine Geriatrics |
44 |
46 |
44 |
34 |
29 |
36 |
35 |
51 |
47 |
71 |
68 |
61 |
Medicine Pediatrics |
14 |
11 |
22 |
20 |
38 |
67 |
132 |
189 |
248 |
249 |
290 |
292 |
Neurology |
248 |
269 |
246 |
248 |
250 |
249 |
199 |
180 |
152 |
131 |
166 |
175 |
Nephrology |
90 |
105 |
92 |
95 |
70 |
71 |
75 |
100 |
150 |
159 |
163 |
168 |
Neonatal Perinatal |
77 |
79 |
66 |
65 |
65 |
50 |
46 |
54 |
41 |
66 |
72 |
100 |
Neurosurgery |
119 |
133 |
129 |
119 |
141 |
127 |
134 |
123 |
136 |
132 |
112 |
142 |
Obstetrics-Gynecology |
843 |
956 |
958 |
1010 |
1050 |
1045 |
1116 |
1060 |
1051 |
1062 |
1075 |
973 |
Psychiatry |
809 |
812 |
744 |
651 |
620 |
526 |
499 |
414 |
438 |
423 |
467 |
390 |
Pediatrics |
1096 |
1018 |
982 |
1023 |
1103 |
1108 |
1220 |
1231 |
1335 |
1409 |
1435 |
1444 |
Physical Medicine |
247 |
251 |
270 |
233 |
226 |
235 |
215 |
217 |
197 |
175 |
153 |
129 |
Plastic Surgery |
176 |
177 |
169 |
161 |
153 |
159 |
140 |
146 |
149 |
131 |
133 |
130 |
Pathology |
252 |
252 |
237 |
270 |
265 |
236 |
218 |
206 |
202 |
189 |
151 |
130 |
Rheumatology |
82 |
85 |
79 |
64 |
47 |
38 |
36 |
34 |
42 |
62 |
85 |
74 |
Neuroradiology |
58 |
87 |
98 |
94 |
74 |
89 |
84 |
85 |
78 |
56 |
58 |
87 |
Radiation Oncology |
147 |
139 |
141 |
124 |
129 |
118 |
119 |
105 |
124 |
79 |
71 |
67 |
Total |
15740 |
15796 |
15424 |
15334 |
15342 |
15375 |
15492 |
15516 |
15940 |
15853 |
15943 |
15952 |
Health Policy Related Increase (managed care and primary care reforms, reports, panic) impacting choice of family medicine for the US MD Grads of 1994 - 1997 and greater retention of internal medicine residents in generalist choices for those in residency at the same time. This group graduated from medical school from 1991 - 1994. |
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Health Policy Related Decrease related to managed care and health reform changes. Hospital support and neurology losses are seen in the 1993 – 1997 class years. The internal medicine career changes impacted earlier class years. |
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Decline/trough for primary care from Medicare, Medicaid, primary care changes, reports. |
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Growth, Demand, More Positions Generalist pediatrics has had steady growth that may be a combination of health policy and admissions of more with commitment to generalist careers, particularly females. Emergency medicine, geriatrics, interventional radiology, and pain management have had growth as recent creations and increased demand. Neprology and dermatology growth involves more positions. Nephrology and obstetrics changes may have also been a result of increasing health policy support from Medicare and Medicaid. |
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Increases As A Recovery or Rebound from managed care/health reform. |
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Subspecialty Training Effect, not a real decline or increase. |
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Lower Demand Or Decision To Limit Position |
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Medicine pediatrics has a greatly distorted appearance in the Masterfile. US seniors matching to MPD increased from 150 to 300 over this time period, but less than 20% of the 1987 – 1990 graduates can be found in medicine pediatrics. Subspecialization in MPD is rapid and progressive, with only a few years involving primary care. |
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Fixed in Place Certain careers are a constant across the time period: Dermatology (255 annual average), General Preventive Medicine (65), Hematology/Oncology and Oncology (173), Neurosurgery (128), Ophthalmology (421), All Orthopedics (559), Otorhinolaryngology (239), Pediatric Cardiology (45), Thoracic Surgery (100), and Urology (226). The limits on how many can enter basically determine the numbers, not medical student choice. |
Attempts to explain career changes through unified theories involving controllable lifestyle, curricula, or grant funding make less sense than an equilibrium concept related to supply, demand, and health policy.
Medicine pediatrics has significant losses down to less than 10% remaining for the 1987 and 1988 graduates when compared to the NRMP match. More "appear" with each class year as fewer have subspecialized and changed away from medicine pediatrics. The most recent levels reflect the most recent graduates. Subspecialization rates may be made worse with health policy involving primary care as seen in declines in internal medicine choice also. Office Based Proportions in IM, FP, Pediatrics, Medicine Pediatrics
Five Periods of Health Policy and Physician Career Choice
Reimbursement and Physician Distribution - follow changes in Medicare funding
Flaws in the Concept of Controllable Lifestyle
Family Medicine Physician Distribution