By Katherine Mangan

After a decade of declines, the number of American medical-school students entering residency programs in family medicine increased 9 percent this year, as thousands participated in Match Day celebrations at medical schools nationwide on Thursday.

Months of anticipation ended at noon for more than 16,000 students when they learned where they would spend the next three to seven years in training as physicians.

This was the largest match in history, with 30,543 applicants participating. Among them were 10,941 students and graduates of international medical schools, 2,045 students and graduates of osteopathic schools, and 1,356 physicians who had graduated earlier from M.D.-granting schools. The National Resident Matching Program posted the results on its Web site.

The biggest news was the long-awaited uptick in family-medicine residencies, which matched 1,169 American students from traditional, M.D.-granting medical schools this year, up from 1,071 in 2009. Those students represented 45 percent of the slots filled in family medicine this year. Most of the rest were taken by graduates of foreign and osteopathic medical schools.

Some medical-education experts said the increase could stem partly from the debate over pending health-care legislation, with its emphasis on the importance of primary care.

Primary Care Has New Appeal

Over the past decade, the number of American medical-school graduates pursuing family medicine has dropped by 52 percent, and many experts are predicting shortages of such physicians as baby boomers age and doctors retire. But high student-loan debts and relatively low pay have turned many medical students away from primary-care careers.

"For a long time, there were questions about the viability of careers in primary care because of the way it's reimbursed at lower levels than for other specialties," said Atul Grover, chief advocacy officer of the Association of American Medical Colleges.

Discussions about health-care legislation, he said, "have highlighted primary care's role and given students more of a sense that they will have a good career in primary care," particularly if their reimbursement levels are raised, as expected, under the proposed legislation.

Lori J. Heim, president of the American Academy of Family Physicians, said the Match Day results could signal a turnaround. She, too, attributed the increase to the recognition in health-legislation talks of the need to reimburse primary-care doctors more and to provide more forgiveness of student loans and debts.

"When I talk to students," she said, "they're very excited about the fact that primary care is being recognized and valued."

She said students may also have been encouraged by the recent push toward a "medical home" model, in which patient care is coordinated by a primary-care physician.

"Students began to realize," she said, "that family physicians will be able to practice the kind of medicine they envisioned when they decided to become doctors."

Primary-care physicians make up 30 percent of physicians in the United States, while subspecialists account for the other 70 percent, according to the family physicians' group.

Two other primary-care specialties — internal medicine and pediatrics — also attracted more American medical-school students this year. Internal-medicine matches were up 3 percent, to 2,722, and pediatrics matches were up 2 percent, to 1,711, among students graduating from American schools.

The matching program uses a computer algorithm to find the closest possible match between the choices of applicants and the directors of teaching hospitals' training programs.