Internal Medicine Shifts Toward Primary Care

Preparation of papers from national studies of the internal medicine workforce

    • July 1, 2002

In 1996, the University of Chicago Center for Health Administration Studies developed and published two papers: one on barriers to primary care training in internal medicine and the other on a comparison of major databases on graduate medical education.

The project was part of the Robert Wood Johnson Foundation (RWJF) national program Generalist Provider Research Initiative.

Key Results

  • In the first paper, The Production of Generalist Physicians for Practice in Internal Medicine: Results from the National Study of Internal Medicine Manpower, the investigator reported:

    • The objective of reaching a 50-50 mix of generalists and specialists in graduate medical education training was widely accepted by directors of training programs in internal medicine in 1993.
    • The rates of subspecialty placements declined, respectively, by about 4 percent and 3 percent in 1994–95 and 1995–96.
    • The principal barriers to a more rapid shift to primary care were a combination of institutional constraints and limited program resources.
  • In the second paper, A Comparison of Graduate Medical Education Databases: Internal Medicine, the investigator reported:

    • There is agreement on the total number of internal medicine residents.
    • There is variation in the reported numbers of first-year internal medicine residents.
    • The reported number of subspecialty fellows varies from 11 percent to 28 percent for the years 1987–93.
    • The universes included in each database are different.
    • The completeness of data collection varies.