Fewer young doctors are choosing general medicine careers, and current training models are unlikely to produce the generalist workforce needed to treat an aging population with multiple chronic conditions, according to a report in the Journal of the American Medical Association.
Researchers from the Mayo Clinic, Rochester, Minn., analyzed data from almost 17,000 third-year internal medicine residents who participated in a survey between 2009 and 2011 and compared their answers on career choice to the answers they gave when they took the survey as first-year residents.
In all, just more than 3,605 of graduating residents were choosing a general internist career, while 10,753 were reporting a subspecialty path. Of those who reported a generalist career plan as first-year residents, only 54.9% were planning to stay on that path by their third year. Among those who had changed career paths, 56.3% were planning a subspecialty career; 36.1% were planning to be hospitalists; 1.1% were choosing a non-internal medicine career; and 6.5% were undecided.
While the total number of residency positions has not increased significantly since 1997, there were 146 internal-medicine residency positions added in 2012. However, they warn, "Expanding medical school enrollment or the number of internal medicine residency positions may simply result in more subspecialists." (At last count, the U.S. had 113,142 new doctors in residency training programs across all specialties.)