Family Medicine Residency Match Is Not a "Field of Dreams".

Workforce projections predict a significant lack of primary care providers nationally. Increased family medicine residency programs and positions have been celebrated as the answer to these projections. Since 2012, the number of positions offered annually has increased almost 2-fold from 2,740 to 5,357. While this has the potential to help alleviate this disaster, very few are questioning the unintended consequences of additional family medicine positions. Over this same 14-year period, the number of programs failing to fill in the National Residency Match Program have increased 4.5-fold (64 to 288) with the number of unfilled slots increasing over 5.5-fold (142 to 805). Linear rates of change for unfilled residency programs per every 1,000 residency positions created have increased from 0.4 prior to 2018 to 69.3 between 2018 and 2021 to 271.5 after 2021. Unfilled programs experience multiple negative consequences including reputation damage and increase coverage responsibilities. Further addition of family medicine training position volume is therefore likely harmful to existing programs. Better solutions should be explored to creatively increase student interest in family medicine by emphasizing and leveraging the value of family medicine physicians and primary care.