Graduate medical education in the United States

The annual surveys of residency programs on which this statistical report is based have had a 95% or higher rate of response for the past five years. The number of accredited programs increased in 1986, primarily as a result of the accreditation of subspecialty programs in internal medicine. The largest number of programs is found in general internal medicine, followed by family practice, general surgery, and obstetrics/gynecology. More than one fifth of the programs are located in the Middle Atlantic region of the United States, with the largest number in the state of New York. The number of positions offered by accredited programs has increased as a result of the increase in the number of specialties with accredited programs. The number of GY-1 positions projected in the fall to be offered the following July has not increased significantly over the past three years. The reader is cautioned that the "number of positions offered" is affected by many factors and is subject to frequent change throughout the year. The number of residents on duty in ACGME-accredited programs increased in 1986 as a result of the increase in number of programs. However, the number of GY-1 residents on duty has decreased by 7% since 1984. This decrease is largely accounted for by the number of FMGs in GY-1 positions, a 21% decrease since 1984. This is especially evident in number of US citizen FMGs in GY-1 positions, a 38% decrease in the same time period. The specific factors that have caused the decrease in number of GY-1 FMG residents are not known at this time. One explanation might be a hesitation on the part of program directors to appoint new FMGs. Another factor could be the lower pass rate of US citizen FMGs on the FMGEMS, one qualification for appointment to an ACGME-accredited program. The number and percentage of women in residency programs continues to increase as it has over the past several years. For example, in 1977 women accounted for only 15% of residents; in 1986 they were 27% of residents on duty. Although female residents are found in nearly all disciplines, two thirds of them are training in family practice, internal medicine, obstetrics/gynecology, pediatrics, or psychiatry.(ABSTRACT TRUNCATED AT 400 WORDS)