Economic factors and the percentage of residency positions filled by United States medical graduates.
OBJECTIVE
To study the association between economic factors and the percentage of specialty residency positions filled by U.S. medical graduates.


METHODS
Data from the 2004 National Resident Matching Program were used to estimate the percentage of residency positions filled by U.S. medical graduates in 15 major specialties. Data from the Medical Group Management Association, American Medical Association, and a major Massachusetts liability insurer were used to estimate the mean and median physician income, work hours, and the relative cost of professional liability insurance.


RESULTS
The percentage of residency positions filled by United States medical graduates varied by specialty. In 2004, U.S. graduates filled more than 90% of the residency positions in orthopedics, plastic surgery, and neurosurgery. In contrast, U.S. graduates filled fewer than 60% of the residency positions in internal medicine and family medicine. A positive correlation between mean annual income and the percentage of residency positions filled by U.S. medical graduates (r = 0.78, P < .001) was observed across the 15 specialties studied. In a multivariate analysis, professional liability costs were not associated with the percentage of residency positions filled by U.S. graduates after controlling for annual income (P = .46).


CONCLUSIONS
Economic factors are associated with the percentage of specialty positions filled by U.S. medical graduates. Procedure-based and hospital-based specialties with an above-average annual income are most likely to have their residency positions filled by U.S. medical graduates.


METHODS
III.
Barbieri
Robert L
RL
Department of Obstetrics and Gynecology and the Brigham and Women's Hospital Physician Organization, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. rbarbieri@partners.org
Anastos
Lisa
L
Michels
Karin B
KB
D002321:Career Choice; D006801:Humans; D007182:Income; D007351:Insurance, Liability; D007396:Internship and Residency / Q000191:economics / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D014481:United States