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Special Communication |

US Graduate Medical Education, 1999-2000

Sarah E. Brotherton, PhD; Frank A. Simon, MD; Sandra C. Tomany, MS
JAMA. 2000;284(9):1121-1126. doi:10.1001/jama.284.9.1121.
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This report examines data collected through the American Medical Association Annual Survey of Graduate Medical Education Programs for 1999-2000 and compares these data with similar data collected during the past several years. The number of resident physicians enrolled during 1999-2000 was 606 more than during the previous year; graduates of US osteopathic medical schools (USDOs) had the greatest proportional increase (5.2%). The number of physicians entering graduate medical education (GME) for the first time in 1999-2000 (n = 22,320) also increased, with the number of USDOs increasing the most, by 14.5%, followed by international medical graduates (IMGs) at 6.5%. Between academic years 1998-1999 and 1999-2000, the number of physicians with prior US GME occupying first-year positions for which prior GME was not required (GY1 positions) increased by more than 300 (12%). Compared with graduates of US allopathic and osteopathic medical schools (USMGs), IMGs were more likely to seek additional training after graduating from a program. However, this was not true of IMGs who were US citizens or who had been naturalized or had permanent residency status. For the second year in a row, the number of white graduates of US allopathic medical schools (USMDs) entering GME has declined (2.0%), while the number of Hispanic GY1 USMDs has increased by 10.5%. The number of Asian GY1 USMDs increased steadily (11.0%) but the number of blacks decreased by 7.1% from 1998-1999. Growth continues, both in numbers and in heterogeneity of physicians in training, and must be considered in the future development of policy to guide US GME.

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Figure 1. Total Number of Resident Physicians in ACGME-Accredited and Combined Specialty GME Programs and Resident Physicians in GY1 Positions, 1994-1999
Graphic Jump Location
ACGME indicates Accreditation Council for Graduate Medical Education; GME, graduate medical education; and GY1, graduate year 1, the first year of education beyond medical school for which prior GME is not required.
Figure 2. Total Number of Resident Physicians, USMD Resident Physicians, and IMG Resident Physicians Training in Primary Care Specialties and Primary Care Combined Specialties, 1994-1999
Graphic Jump Location
USMD indicates US allopathic medical graduate; IMG, international medical graduate. Data shown are for resident physicians training in the primary care specialties of family practice, internal medicine (including approximately 1500 preliminary positions in internal medicine each year), and pediatrics, and in the combined specialties of internal medicine/pediatrics and internal medicine/family practice.
Figure 3. Number of USMD Resident Physicians Entering GY1 Positions in ACGME-Accredited and Combined Specialty GME Programs by Race/Ethnicity, 1996-1999
Graphic Jump Location
USMD indicates US allopathic medical school graduate; GY1, graduate year 1, the first year of education beyond medical school for which prior graduate medical education (GME) is not required; and ACGME, Accreditation Council for Graduate Medical Education.

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