Are the recommendations of the AAMC's task force on the generalist physician still valid?

A few years ago, most opinion leaders and workforce analysts believed that the number of generalist physicians in the United States was much too low. The AAMC responded to this concern by convening a task force to review the evidence bearing on the U.S. supply of generalist physicians and to make recommendations for action by the AAMC and its member institutions. In 1992, the task force called for at least half the graduates of U.S. allopathic medical schools to enter practice as generalists and for medical schools to design their educational programs to promote an affinity for generalism among their students. Since that time, however, research findings have suggested that the current size of the country's generalist physician workforce in relation to projected need may indeed be adequate. In light of these recent observations, the authors asked whether the task force's major recommendations remain valid. In this article, they state their reasons for thinking that it definitely does. After reviewing the recent research findings mentioned above, the authors show that simply to maintain the current size of the generalist physician workforce, a marked increase will be needed in the number of U.S. medical school graduates who choose to become generalists. In the aggregate, this amounts to roughly half the graduating classes of LCME-accredited medical schools, as called for by the AAMC in 1992. (The authors predict that international medical graduates will not make up a significant percentage of the country's generalist workforce, and that U.S. medical school graduates will be the predominant source of these physicians in the future.) Equally important, the new educational approaches being created by medical schools to embed generalism in their curricula are necessary to ensure that all graduates, regardless of their specialty choices, be well grounded in the principles and skills of "general physicians" so they can function well in the new health care system that is rapidly evolving.