The National Study of Internal Medicine Manpower: XX. The Changing Demographics of Internal Medicine Residency Training Programs

doi:10.1059/0003-4819-121-6-199409150-00008

The National Study of Internal Medicine Manpower: XX. The Changing Demographics of Internal Medicine Residency Training Programs

Christopher S. Lyttle, MA; and
Gerald S. Levey, MD

From the University of Chicago, Chicago, Illinois and the University of California, Los Angeles, Los Angeles, California. Requests for Reprints: Christopher S. Lyttle, MA, Center for Health Administration Studies, University of Chicago, 969 East 60th Street, Chicago, IL 60637. Grant Support: By the American Board of Internal Medicine, the American College of Physicians, the American Society for Internal Medicine, the Association of Professors of Medicine, the Association of Program Directors in Internal Medicine, and the Society for General Internal Medicine.

Abstract

Three annual physician workforce surveys of internal medicine residency programs from 1990-1991, 1991-1992, and 1992-1993 show that changes in the demographic characteristics of internal medicine residents detected in the period 1986-1989 have been sustained; specifically, more women and international medical graduates are entering internal medicine. Women and international medical graduates now compose 32% and 36% of internal medicine trainees, respectively. The percentage of U.S. medical graduates was lower in traditional 3-year (categorical) tracks (64%) and highest in preliminary tracks (1 year of internal medicine leading to another specialty) (87%). Approximately 1500 more first-year residents than positions offered through the National Residency Matching Program were reported in 1992-1993. This suggests that many programs concentrate their recruiting efforts outside the Matching Program. The data also show a continuing high subspecialization rate for residents who complete 3 years of training in internal medicine (approximately 60%), although about one third do not go directly into subspecialty training. We discuss the implications of these findings for the national goal of increasing the number of primary care physicians.