Results of the 1998 National Resident Matching Program: family practice.

The 1998 National Resident Matching Program (NRMP) results reflect a change in the perceptions and choices of physicians entering graduate medical education in the United States. Ninety-one fewer positions were filled in family practice residency programs in 1998, as well as 21 fewer in primary care internal medicine, 12 fewer in primary care pediatrics, and 13 fewer in internal medicine-pediatric programs. In contrast, 49 more positions were filled in anesthesiology, and 12 more US seniors chose diagnostic radiology, two "marker" disciplines that have recently been market sensitive. Thirty-four more positions were also filled in each of categorical internal medicine and pediatrics programs, where trainees are "pluripotential" with perceived options for practicing as generalists or entering subspecialty fellowships, depending on the market. While the demands of managed care and the needs of rural and underserved populations continue to offer a market for family physicians, family practice may have experienced a "primary care backlash" though the 1998 NRMP.