Why are Family Medicine Residency Faculty:Trainee Ratios So Low?

[Mad Jack]

I've just been noticing that, when I compare FM to most other specialties, the faculty:resident ratio is quite low.

Let's look at SUNY Brooklyn Family Med:
Program Faculty
Faculty type Physician Non-physician
Total 16 2

Total program size: 18

That adds up to a 1:1 faculty:resident ratio.

Now let's look at SUNY Brooklyn IM:
Program Faculty
Faculty type Physician Non-physician
Total 235 0

Total program size
Year Positions
1 50
2 47
3 44

This gives the IM side of things a 1.67:1 faculty:resident ratio.

Now here's UCONN
Program Faculty
Faculty type Physician Non-physician
Total 10 4

Total program size: 21

0.66:1 faculty:resident ratio

Now here's UCONN IM
Program Faculty
Faculty type Physician Non-physician
Total 159 29

That gives you a 1.48:1 faculty:resident ratio.

This also held up when I compared FM to fields other than IM- Anesthesia, EM, whatever. So I guess my question is, why do FM residencies have such low levels of faculty in comparison to other fields, and why are their programs so small? Does this lack of faculty impact training, or are the faculty in other programs kind of superfluous and just an effect of granting everyone in a large department faculty status even if their teaching responsibilities are rather limited? It just makes me worry that in any FM program that isn't unopposed, I'd just be drowned out by all of the IM, peds, or whatever residents in trying to get training. Plus I just wonder why there aren't more FM spots in general- FM programs are tiny compared to IM, and there just aren't a lot of positions to go around in certain areas I'd like to live due to a lack of programs.

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[DrMidlife]

Faculty/resident ratio isn't a very interesting stat, imho. Too many variables in that number. Are FM docs teaching L&D, or are ObGyn docs? If ObGyn, are they counting that as faculty for the FM residents?

It just makes me worry that in any FM program that isn't unopposed, I'd just be drowned out by all of the IM, peds, or whatever residents in trying to get training.

Yup. I didn't even apply to any programs that start with a U, for this reason.

Plus I just wonder why there aren't more FM spots in general

You say "general" and then you say "certain areas". Alaskan docs are 90% FM overall. Great unopposed training up there, no sharing with other residents. Rugged rigor.

I think if you look up the percentages of FM docs in practice in your certain areas of interest, you'll see that the residency percentages match up. How many of the people you know in NYC have an FM doc as their PCP vs. an IM doc? How many women see an FM doc for their girl parts vs. their gynecologist?

Also Hawaii only has 2 FM residencies, which might make it a better comparison to NYC. It's really really easy to recruit docs to work in Honolulu, so HI lacks the motivation to fund more residency positions.

- FM programs are tiny compared to IM, and there just aren't a lot of positions to go around in certain areas I'd like to live due to a lack of programs.

Gotta go with cry me a river on this one. Compare non-FM residency spots in Washington state (my home) and Oregon (my envy) to pretty much anything east of the Mississippi. There's exactly one ObGyn program in OR, one in WA. There are 6-7 ObGyn programs and 6-7x as many residency seats in MA, CT with same populations. I would have been much more committed to ObGyn over FM if I didn't want to be home. But WA & OR have boatloads of FM spots because those states make up 30% of the US land mass, much less densely populated than the east coast, dominated by remote rural areas. My two home towns are a six hour drive apart, which on the west coast is nothing.

Unopposed full spectrum community FM is everything I thought it would be and then some. These are totally my people. Look into Lancaster PA, Lawrence MA, Concord NH.

Best of luck to you.