Training the internist for primary care: a view from Nevada

Area of Science:

• Medical Education
• Internal Medicine
• Primary Care Physician Training

Background:

• The establishment of primary care residencies raises questions about local and national training priorities.
• Decreasing healthcare training funds necessitate a reevaluation of physician training models.
• Primary care internal medicine offers unique patient benefits compared to family practice or subspecialist primary care.

Purpose of the Study:

• To address the need for enhanced training and academic credibility in primary care internal medicine.
• To propose structural changes in internal medicine residency programs to better serve primary care needs.
• To explore options for nationalizing and standardizing primary care internal medicine fellowship training.

Main Methods:

• Analysis of current primary care internal medicine training structures.
• Proposal of a modified residency program with an additional year for primary care focus.
• Suggestion for a dedicated two-year primary care fellowship with specialized board examination.

Main Results:

• Current primary care internal medicine training may lack sufficient emphasis and academic recognition.
• Proposed changes aim to produce general internists with specialized primary care skills.
• A dedicated fellowship would offer comprehensive training and establish a subspecialty.

Conclusions:

• The University of Nevada has an opportunity to pioneer a strong primary care internal medicine residency.
• National changes are needed to address the emphasis on primary care within internal medicine.
• Implementing proposed training modifications would enhance physician competency and redirect certification efforts.