A National Survey of Internal Medicine Primary Care Residency Program Directors

J Gen Intern Med. 2019 Jul;34(7):1207-1212. doi: 10.1007/s11606-019-04984-x. Epub 2019 Apr 8.

Abstract

Background: The United States is facing a primary care physician shortage. Internal medicine (IM) primary care residency programs have expanded substantially in the past several decades, but there is a paucity of literature on their characteristics and graduate outcomes.

Objective: We aimed to characterize the current US IM primary care residency landscape, assess graduate outcomes, and identify unique programmatic or curricular factors that may be associated with a high proportion of graduates pursuing primary care careers.

Design: Cross-sectional study PARTICIPANTS: Seventy out of 100 (70%) IM primary care program directors completed the survey.

Main measures: Descriptive analyses of program characteristics, educational curricula, clinical training experiences, and graduate outcomes were performed. Bivariate and multivariate logistic regression analyses were used to determine the association between ≥ 50% of graduates in 2016 and 2017 entering a primary care career and program characteristics, educational curricula, and clinical training experiences.

Key results: Over half of IM primary care program graduates in 2016 and 2017 pursued a primary care career upon residency graduation. The majority of program, curricular, and clinical training factors assessed were not associated with programs that have a majority of their graduates pursuing a primary care career path. However, programs with a majority of program graduates entering a primary care career were less likely to have X + Y scheduling compared to the other programs.

Conclusions: IM primary care residency programs are generally succeeding in their mission in that the majority of graduates are heading into primary care careers.

Keywords: medical education-career choice; medical education-graduate; medical student and residency education; primary care; survey research.

MeSH terms

  • Career Choice*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Internal Medicine / methods
  • Internal Medicine / trends*
  • Internship and Residency / methods
  • Internship and Residency / trends*
  • Male
  • Physician Executives / trends*
  • Primary Health Care / methods
  • Primary Health Care / trends*
  • Program Evaluation / methods
  • Program Evaluation / trends
  • Surveys and Questionnaires*
  • United States