Kahn N B, Garner J G, Schmittling G T, Ostergaard D J, Graham R
Division of Education, American Academy of Family Physicians, Kansas City, MO, USA.
Fam Med. 1998 Sep;30(8):564-70.
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.
1998年全国住院医师匹配计划（NRMP）的结果反映了进入美国毕业后医学教育的医生在观念和选择上的变化。1998年，家庭医学住院医师项目的岗位填补数量减少了91个，初级保健内科减少了21个，初级保健儿科减少了12个，内科 - 儿科项目减少了13个。相比之下，麻醉学的岗位填补数量增加了49个，有12名美国高年级学生选择了诊断放射学，这两个“标志性”学科最近对市场很敏感。分类内科和儿科项目的岗位填补数量也各增加了34个，在这些项目中，受训人员具有“多潜能”，根据市场情况，他们可以选择成为全科医生或进入专科 fellowship项目。虽然管理式医疗的需求以及农村和服务不足人群的需求继续为家庭医生提供市场，但通过1998年的NRMP，家庭医学可能经历了一次“初级保健反弹”。
