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Major concerns about internal medicine: insights from program directors.

Janet Record¹, Brent Beasley, Furman S McDonald

¹Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. jrecord2@jhmi.edu

Southern Medical Journal

|January 6, 2011

Summary

Internal medicine residency directors identified key challenges, including declining interest in the field, excessive regulations, economic pressures, and work hour limits. Addressing these issues is crucial for the future of internal medicine and primary care.

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Area of Science:

Medical Education
Internal Medicine Workforce
Healthcare Policy

Background:

Internal medicine faces challenges impacting physician interest and workforce stability.
Residency program directors offer unique insights into the field's difficulties.

Purpose of the Study:

To identify and characterize the primary concerns of internal medicine residency program directors.
To understand factors contributing to waning interest in internal medicine careers.

Main Methods:

A 2007 survey was distributed to internal medicine program directors by the Association of Program Directors in Internal Medicine (APDIM).
An open-ended question asked directors about their major concerns regarding internal medicine.
Responses underwent content analysis by two independent investigators to identify key themes.

Main Results:

186 out of 236 (79%) program directors responded to the survey.
Five major themes emerged: waning interest (especially in primary care), regulatory oversight, economic pressures, the eighty-hour work week, and internal medicine fragmentation.
Respondents represented diverse roles (general internists, various academic ranks) and geographic regions.

Conclusions:

Internal medicine residency directors possess critical insights into the declining interest in the field.
Addressing concerns like workforce crisis, regulatory burden, and economic factors is vital to reinvigorate interest in internal medicine.
Collaboration among stakeholders is necessary to influence healthcare policy and improve the field's appeal.