Restructuring an internal medicine residency program to meet regional and national needs for general internists

Area of Science:

• Medical Education
• Internal Medicine Training
• Primary Care Development

Background:

• Residency programs traditionally emphasized subspecialty training.
• A need exists to increase general internists and primary care physicians, especially in underserved regions.

Purpose of the Study:

• To describe the reorganization of the University of Washington's internal medicine residency program.
• To evaluate the impact of this reorganization on resident career choices and regional physician distribution.

Main Methods:

• Reorganization of the internal medicine residency program.
• Establishment of new community hospital teaching services.
• Expansion of clinical training sites to Montana, Idaho, and Eastern Washington.
• Introduction of primary care residency tracks.

Main Results:

• A significant shift in resident career plans occurred, with nearly two-thirds of recent graduates pursuing general internal medicine.
• Many graduates intend to practice in smaller cities and towns within the region.
• The program successfully increased interest in primary care.

Conclusions:

• The reorganized residency program effectively redirects trainees towards general internal medicine and primary care careers.
• This model can foster regional graduate medical education and address physician shortages in smaller communities.