General internists and subspecialists

Article Abstract:

The shortage of primary care physicians will have a significant effect on the discipline of internal medicine. The US wants to increase the proportion of primary care physicians to 50% of all practicing physicians. The Federated Council for Internal Medicine would like 50% of the graduates of internal medicine residency programs to become general internists. Two articles examine these goals. One found that increasing the number of residents who become general internists to 50% may not affect the shortage of primary care physicians significantly. An increase to 75% would be more effective, but this goal is probably not obtainable within the next several years. The other study proposes increasing the basic training of internists to four years. In this expanded program, residents would be trained in more subspecialty areas. This would reduce the need for referrals to other physicians for services and consultations.

Editorial

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The future of generalism

Article Abstract:

A strategy needs to be developed to increase the number of physicians who practice general internal medicine. The number of residents in internal medicine who have chosen subspecialities has increased. The growth of subspecialization has had a serious impact on the provision of health care services. It has increased health care costs and decreased the availability of primary health care services to adults. The quality of health care has also been affected. Physicians who practice internal medicine need to accept their responsibility for providing primary care. Doctors who practice general internal medicine would be able to provide less fragmented health care to patients at several different levels. They would also be able to decrease health care costs and improve the quality of care. The expansion of general internal medicine would hopefully attract more medical students and residents.

Column

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Internal medicine and the journey to medical generalism

Article Abstract:

Different strategies have been developed to address the shortage of primary care physicians. The Federal Council of Internal Medicine has recommended that 50% of the graduates from internal medicine residency programs become general internists. The internal medicine community has also developed a strategy for increasing the number of primary care physicians. It has recommended that students receive exposure to general internal medicine during medical school. Students may get this type of exposure most successfully in different settings for outpatient care outside the hospital. An accelerated program that combines medical school and residency training may also encourage more students to choose general internal medicine. Different changes in residency training programs may help prepare general internists for practice in managed health organizations.

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