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ToggleFamily medicineis a specialty in which all medical students rotate during the third year of medical school. If you suspect primary care or family medicine might interest you, we recommend trying to schedule your core family medicine rotation as early in thethird yearas possible. Since many medical students often have choices about where to rotate, we suggest completing the family medicine rotation at the student’s most prestigious family medicine clerkship location and preferably at a location that has a residency program. By the same token, it is important to schedule your family medicine sub-internship early in the fourth year and also at your medical school’s most prestigious site.
Family medicine residency starts in the PGY1 year and is three years in total. The vast majority of family medicine graduates do not complete fellowship training. The top family medicine programs are very competitive so it is important to understand what your target programs will be. Themajority of U.S. allopathic seniors matchin family medicine, but, the specialty remains competitive for international and osteopathic applicants.
US Allopathic Seniors
In 2018, there were a total of 3,629 family medicine positions offered in the NRMP match and a total of 4,402 applicants for those positions.
Family Medicine Elective/Audition Rotations
Interestingly, family medicine is not a specialty that whole heartedly recommends audition rotations. In 2018, 66% of program directors surveyed felt this was an important factor when deciding whom to interview. There may be some program directors at more competitive programs who feel more strongly that audition electives as a way to gain exposure to another institution, prove yourself on another “turf” and to have letters of reference from somewhere other than your home institution. Where to complete audition electives will largely depend on your competitiveness as an applicant and geographic preferences. Ideally, audition electives should be completed by October of the application year. For family medicine in particular, it is important to discuss the possibility of doing audition rotations with an advisor or mentor from your home medical school. For most medical students, away rotations are not necessary regardless of where you hope to match.
Family Medicine Letters of Reference
Letters of reference from academic family medicine physicians with whom you have worked directly are the most important letters in your profile. If possible, strong letters of reference from leaders within an academic family medicine department, such as a chair, program director, or clerkship director will also bolster your overall candidacy. Since perceived commitment to family medicine is of the utmost importance to family medicine program directors, having letters that can communicate your commitment is vital. If you have done any family medicine or public health research, a letter of reference from the principal investigator with whom you worked is also valuable. We recommend a minimum of two letters from academic family medicine physicians with other letters of reference from primary care academic physicians or researchers with whom you have worked.
Cumulatively, 4,402 applicants applied for 3,629 family medicine residency positions in 2018. Of those 4,402 applicants, 1,635 were U.S. senior medical students. A mere 77 U.S. senior family medicine applicants did not match in to family medicine residencies last year. Therefore, 4.7% of allopathic U.S. senior family medicine applicants did not match making family medicine one of the least competitive specialties based on the data. Keep in mind, however, that the most desirable family medicine programs are extremely competitive.
This is the data for those U.S. senior medical students who matched successfully:
Cumulatively, 4,402 applicants applied for 3,629 family medicine residency positions in 2018. There were 673 osteopathic applicants. Of those, 610 matched. Therefore, 91% of osteopathic medical student family medicine applicants matched in family medicine.
The data for those osteopathic students who matched successfully:
Family medicine is one of the less competitive specialties for osteopathic medicine students. Average COMLEX and USMLE scores for applicants who match are significantly lower than in other specialties.
Cumulatively, 4,402 applicants applied for 3,629 family medicine residency positions in 2018. There were 1,166 U.S. IMGs who applied for family medicine. A total of 600 matched. Therefore, 51% of U.S. IMG family medicine applicants matched.
Below is the data for those US IMG applicants who matched successfully:
Because approximately half of all U.S. IMG applicants to family medicine match successfully, we suggest applying as broadly as possible and being honest about how competitive you are. When reviewing Doximity residency rankings on Doximity Residency Navigator, pay attention to “feeder” schools for each program.
IMG Family Medicine Residency Match
Cumulatively, 4,402 applicants applied for 3,629 family medicine residency positions in 2018. A total of 679 non-US IMGs applied and 267 matched. Therefore, a total of 39% of non-US IMG family medicine applicants matched in family medicine.
Below is the data for those non-US IMG applicants who matched successfully:
Because less than half of all non-U.S. IMG applicants to family medicine match successfully, we suggest applying as broadly as possible and being honest about how competitive you are. When reviewing Doximity residency rankings on Doximity Residency Navigator, pay attention to “feeder” schools for each program.
Based on the 2018 Program Director’s Survey published by the NRMP, there are many factors that are important in deciding whom to invite for an family medicine residency interview. What is most interesting about family medicine is that standardized test scores, personal statement, and perceived commitment to the specialty are the most important factors in deciding whom to interview. Below we discuss these factors further.
1) USMLE Step 1/COMLEX Level 1 score and Step 2 CK/COMLEX Level 2 CE Score
It is a fact of life that your performance on Step 1 or COMLEX 1 will impact the likelihood that your application is “screened in” and that you will be invited for an interview. The 2018 Program Director’s Survey indicated that 62% of programs require a “pass only” on the USMLE Step 1 and only 38% have a target score. The average number for that cutoff or “target score” is 205. Fifty percent of programs will often consider applicants with a Step 1 failure. By the same token, some programs automatically grant interviews for students with scores above a certain threshold. That threshold varies but is typically 220 or higher for Step 1. Keep in mind that not all programs offer automatic interviews. If you don’t do as well on Step 1 as you would have liked, take Step 2 CK early in the fourth year and do as well as you can!
Your score on Step 2 CK/COMLEX Level 2 CE score is also very important for program directors when deciding whom to interview. Therefore we suggest that most applicants take this exam early in the fourth year. Similar to Step 1, 40% of program directors indicated they require a “pass only” on the exam.
Your score on Step 3 (if you have already graduated from medical school) really doesn’t influence much as 95% of programs don’t use this score.
2) Personal Statement, Perceived Commitment to Family Medicine and Letters of Reference
In contrast to other specialties, the personal statement and perceived commitment to the specialty take priority in deciding whom to interview. How does a program director glean your interest in the specialty? This is largely based on your personal statement content, demonstrated interest based on rotations in the specialty and letters of reference. Other specialties in medicine are very “numbers-focused” yet family medicine is not one of them. Program directors want to know that you are committed to primary care and the diverse nature of practice. Strong endorsements of your candidacy are also extremely influential in deciding who receives interviews.
29% of programs extend family medicine interviews before October 1st and 41% extended them during the month of October. Therefore, it is important to send your ERAS application in early!
Now, assuming you are selected for an interview, what factors influence how (and if) you are ranked?
Here’s the list:
As you can see, after the interview, it is your “interview performance,” interpersonal qualities, and how you are perceived by anyone and everyone you meet that will influence how you are ranked (and even if you are ranked) the most. This is why, no matter how strong an applicant you are, it is important to be comfortable with the interview process. It is also valuable to know yourself; are you an introvert or more of an extrovert? What types of social situations make you comfortable or uncomfortable? During residency interviews you will be meeting many new people and having numerous conversations with strangers. You also need to clearly convey your commitment to family medicine. Be prepared!
Family medicine takes in to account not only your interview performance, but, they want to know what current residents thought of you, too!