Internal Medicine Interest Group of the Month: Cornell University
One of the more troubling trends in health care today is that medical students have increasingly chosen to match into surgical subspecialties to the exclusion of more generalist specialties, including pediatrics, primary care, geriatrics, and of course, internal medicine. This is not some minor "Scrubs-style" J.D. versus Turk, medicine versus surgery debate. In fact, those going into internal medicine are also not immune to this growing affliction, since many who enter internal medicine residencies end up subspecializing. What is disturbing about this trend is that as the over 70 million baby boomers in the United States develop multiple chronic conditions, there might not be enough generalists to meet the nation’s growing needs.
Perhaps as an effect of this growing disinterest in primary care, the Internal Medicine Interest Group (IMIG) at Cornell had not been active for a while and was only recently restarted two years ago, similar to our peers at Stanford and Columbia. Although no one person or one group can single-handedly reverse this trend, we hope that by exposing more students to the diversity of internal medicine, we can at least stem the tide.
The new leadership of the IMIG at Weill Cornell—composed entirely of the Class of 2010—took over in late April just as the Class of 2009 was beginning to study for the dreaded boards. For our first event we assembled a panel of fourth-year students that had recently matched into internal medicine and had them give a talk entitled "How to Match into Internal Medicine." We made sure to represent several locations (rural and metropolitan as well as different regions of the country) and several programs with different focuses (that is, more research versus more clinical). One of the most pervading themes of the panel was that there was in fact no one right way to match into internal medicine, as the students on the panel had such different experiences in medical school. For example, during the summer after first year, some went to Africa, a few did basic science research here in the city, and others did clinical research related to geriatrics on a Weill Cornell-specific scholarship. Another important take-home point was that neither grades nor board scores define an applicant. That is, most programs take a holistic approach to the match process, perhaps echoing the holistic way in which internists practice.
To celebrate National Primary Care Week in mid-October, we teamed up with the interest groups in pediatrics, geriatrics, primary care, and OB/GYN to bring together a panel of primary care physicians to speak on why they went into primary care and to discuss the joys and frustrations they have experienced. We will soon be screening the movie Sicko by Michael Moore and use it as a springboard to discuss the current health care system in the United States and to highlight possible improvements that can be made. And in the spring, we have planned a talk on the subtleties of immigrant health and a panel on the many career paths of internal medicine. We are also outlining plans on a "meet and greet" with internal medicine faculty, shadowing opportunities, a talk on going into academic medicine, and developing a database of past students who matched into internal medicine.
Every step of the way we have been supported intellectually by our interest group advisor, internist Suzanne Wenderoth, MD, FACP, and supported financially by the ACP. We hope that through our efforts and through subsequent iterations of our interest group, we can help shift students back to practicing medicine in the Oslerian tradition.
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