Internal medicine residency programs continue to grow but policies needed to ensure patient access to general internists

Philadelphia, March 16, 2018 -- The 2018 Main Residency Match revealed that internal medicine continues to be the largest training specialty, offering over one-quarter (26.2 percent) of all PGY-1 positions in the Match. Internal medicine programs offered 7,542 categorical positions and 374 primary care positions, an increase of 309 categorical positions (4.3 percent) and 33 primary care positions (9.7 percent) from the 2017 Match. Of these positions, 7,733 (97.7 percent) were filled, 3,424 (44.3 percent) by U.S. medical school seniors.

“The overall increase in the number of matched internal medicine positions is essential to ensure that patients have access to general internal medicine and primary care physicians who specialize in preventive care, diagnostic evaluations, acute problem management, and long-term care for complex conditions,” said Davoren Chick, MD, FACP, senior vice president of medical education, American College of Physicians. “However, currently only about 18 percent of graduating internal medicine residents report planning a career in general internal medicine, with an additional 14 percent planning to pursue hospital medicine.”

Combined internal medicine enrollment numbers have increased every year since 2012: 5,526 in 2012; 6,573 in 2013; 6,798 in 2014; 7,037 in 2015; 7,263 in 2016; 7,442 in 2017; 7,542 in 2018. During this same period, the percentage of U.S. seniors matching to postgraduate year one (PGY-1) internal medicine positions has been declining, and was again lower in 2018 (44.3 percent) , another 5 percent decline from 2017 (46.6 percent).

“Internists provide essential cognitive expertise and interpersonal skills needed to make an accurate diagnosis, propose a patient-centered treatment plan, communicate with patients and their families, and coordinate care across our complex health care system,” Dr. Chick said. “To ensure access to personalized care for future patients, we must continue to address barriers to careers in general internal medicine, including administrative burdens, under-recognition of cognitive skills, and inequities in compensation models.”

As the overall number of graduate medical education training positions offered nationally has increased, the percentage of those slots filled by U.S. medical school seniors has steadily decreased, and the percentage filled by international medical graduates has steadily increased. “This trend is reflected in ACP’s ongoing support for our international members, and raises concern for possible negative effects of travel restrictions for international physicians,” said Dr. Chick.

The number of positions offered in internal medicine-pediatrics in 2018 (382) has been relatively unchanged since 2015 (380), with 98.7 percent of those positions filled, 80.1 percent by U.S. medical school seniors.

About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.


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