While the number of American medical students entering categorical internal medicine training programs was virtually identical to last year (2,668 for 2006 vs. 2,659 for 2005), other indicators show a continuing gravitation of residents toward eventual careers in the medical subspecialties rather than primary care.
According to Steven E. Weinberger, MD, FACP, ACP senior vice president for medical knowledge and education, "Data from a residency questionnaire show a progressive fall in the percentage of graduating internal medicine residents planning careers in general medicine. In 1998, 54 percent of graduating residents were choosing to go into general internal medicine; the comparable number for residents graduating in 2005 was only 20 percent."
More students are entering combined medicine-pediatrics training programs this year, 294 compared with 275 in 2005, representing a 7 percent increase. ACP continues to be concerned with the increase in students choosing combined or specialized fields in favor of general internal medicine. Internists are expert diagnosticians who can treat and manage chronically ill patients with one or multiple complex and interactive illnesses. Internists also are experts in evidence-based disease prevention, early detection of disease, medication management, and health promotion. They serve as consultants when patients have difficult, undifferentiated problems and may also have special areas of expertise.
The need for physicians to care for patients with chronic and complex illnesses will increase substantially as the U.S. population ages. Within only five years, the first of a wave of 76 million baby boomers will begin to be eligible for Medicare. The population age 85 and over, which is most likely to require chronic care services for multiple conditions, will increase 50% from 2000 to 2010. It will more than double by 2030, and more than quadruple by 2050.
Earlier this year ACP warned that primary care is on the verge of collapse, and if trends continue, there will not be enough internists to care for an aging population, leading to higher costs, lower quality, and greater inefficiency.
ACP (Doctors of Internal Medicine. Doctors for Adults.(R)) is the largest medical-specialty organization and second-largest physician group in the United States. Membership includes physicians who provide comprehensive primary and subspecialty care to tens of millions of patients, including taking care of more Medicare patients than any other physician specialty. Internists specialize in the prevention, detection and treatment of illnesses in adults. ACP works to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine.
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