Are we training too many medical subspecialists?

As of 1983, 10% to 40% of cities with a population of 200,000 to 500,000 lacked a board-certified physician in one or more medical subspecialties, and many additional cities of this size had only one certified representative in many of the subspecialties. Somewhat smaller cities (population, 125,000 to 200,000) had far less complete coverage. Even when one includes board-certified internists who declared themselves subspecialists but lacked certification, there were many relatively large cities without complete coverage. Between now and 2000, an appreciable portion of the projected larger pool of board-certified subspecialists will be required to deal with a growing population and an increase in per capita demand for care. Others will locate in underserved or underserved cities, but our data suggest that even in 2000, many relatively large cities will have a deficit of most types of subspecialists.