Physician Pipeline Production: Peak or Plateau.

The peak number of graduate medical education (GME) appointees in Louisiana was in 2013, as was the peak number of graduating senior medical students. This was followed in the next three years by a pause or plateau in each physician pipeline category, and preceded by a slow, steady rise during the six years after Hurricane Katrina 2006-2012. Katrina made a large impact in destruction, disruption, and displacement; but the acute subsided and the chronic recovery is ongoing. For a more inclusive total of GME, the National Resident Matching Program (NRMP) Fellowship match numbers were added to the main NRMP match. Filling a slot in the matches is getting progressively harder for candidates, as the trend lines of GME openings and PGY-1 applicants come closer together. Both medical student graduates and PGY-1 go up, but more graduates than GME open slots proportionately make individual competition higher.The retention and/or return of these mobile young physicians is good in Louisiana comparatively; many GME slots are filled with those from outside the state, resulting in a high match filled percent.