(HealthDay)—U.S. M.D. graduates make up half the entering first-year class of family medicine residencies, and the increase in postgraduate year 1 (PGY-1) family medicine and primary care positions is lagging behind that of non-primary care specialties, according to two studies published in the October issue of Family Medicine.

Stanley M. Kozakowski, M.D., from the American Academy of Family Physicians, and colleagues examined the entry of medical school graduates into residencies in 2016-2017. The researchers found that U.S. M.D. graduates made up 49 percent of the entering first-year class of family medicine residencies accredited by the Accreditation Council for Graduate Medical Education, which was not significantly different from the 11-year average of 46 percent. Over the same period, there was a 1 percent annual increase in the percentage of D.O. graduates in the entering class and a reciprocal decrease in the percentage of international graduates.

In a second study, Kozakowski and colleagues used data from the National Resident Match Program (NRMP) and the American Osteopathic Association Intern/Resident Registration Program for family medicine and primary care positions. The researchers found that PGY-1 family medicine and primary care positions continue to grow in the NRMP, but compared with the growth of non-primary care specialties, they have lost ground. D.O. students have been displacing non-U.S. citizen international medical graduates in accredited programs, while the proportion of U.S. seniors has remained stable.

"A major overhaul of the medical education system is required to align the medical education system with the transformation of the health care system needed to improve quality, population health, and cost control," write the authors in the second study.