How To Be Successful in The Match

Every Match Day, a number of medical schools claim that far greater numbers of students are going into primary care than actually are because the schools’ calculations don’t account for the many who match into internal medicine who will ultimately subspecialize and never practice primary care.

Still, some are truly training large numbers of primary care doctors. University of Minnesota Medical School – Duluth campus faculty Jim Boulger, PhD, shares his views on the topic in this opinion piece.

"How To Be Successful in the Match" was originally shared by Primary Care Progress and later published in the University of Minnesota Family Medicine and Community Health newsletter.

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Jim Boulger, PhD

By Jim Boulger, PhD

The University of Minnesota Medical School – Duluth campus affirms within its mission statement that our goal is to train excellent family physicians that will serve rural and Native American populations. We are very successful at these tasks.  

Why?

It begins, as we all would expect, with selection. If the wrong folks come in, the wrong folks go out. We actively select applicants who are from smaller communities and have a demonstrated interest in family medicine; have been academically successful; and hold decent MCAT scores. When we interview these folks, we try to be as holistic as possible, respecting their uniqueness but always with the institutional mission “fit” in mind.

Duluth campus medical students—all of them—are required to participate in our Rural Medical Scholars Program. This means spending about five weeks in smaller communities, some as far as 300 miles away, over the first two years of medical school. While in these communities, most students move in with a family physician and his or her family. They are required to perform community assessments, but the majority of their time is spent seeing patients. Additionally, in the first year they spend seven mornings or afternoons in the offices of family doctors in the Duluth area. Many of the students also enroll in the Rural Physician Associate Program, which is a nine-month elective training experience placing each in a rural community during their third year of medical school.

Teasing apart the potency of the various components, e.g., admissions, curricular emphases, etc., is very difficult; but, I do think that it is clear the combination really works well. Of course, not all students elect family medicine as a specialty or end up in rural or Native American practice sites. Education should – and does – change us. So students may come in on the family or rural medicine track, but that doesn’t guarantee they will all leave that way. Still, we can boast that we are wonderfully successful.

Of the 1,748 students who have matriculated in Duluth since 1976, 836 have selected family medicine as their specialty. Forty-four percent of those in practice are in communities of 20,000 or less.

Many will protest that this cannot be done elsewhere. But I usually try to distinguish between what can be done and what we really want to have happen. Our behavior is more important than our pledges. If we wish to change the mix at the end of medical school—at Match time—we have to change what happens at admissions and during the medical school years. Doing the same thing again and again, but expecting different results, is one definition of psychopathology. We know that if we want to see real change in health, we must see change in lifestyle. If we want to see change in who populates our practices of medicine in the future, we must change how we function in academia. The same old stuff will not work.

Our nation needs change from us. We can make the changes necessary. But do we have the will to act? I don’t think we can wait much longer for the answer.

Jim Boulger, PhD, has been involved with medical education on the University of Minnesota – Duluth campus for more than 40 years.