Attracting internal medicine trainees to rheumatology: where and when programs should focus efforts.

OBJECTIVE: To determine where and when efforts should be focused to increase recruitment of rheumatology trainees from internal medicine (IM) programs.
METHODS: (1) We calculated the percentage of trainees at each of the 13 English-speaking Canadian IM-accredited programs who entered a rheumatology training program in Canada from 2005 to 2007. We then correlated this with the opportunity they would have had to do a rheumatology rotation in each of their 3 postgraduate years of IM training. (2) We calculated the overall percentage of residents who remained at the same training institution after their IM program, 2005-2007, comparing this to 4 similar-size subspecialty training programs.
RESULTS: Among IM trainees, 3.5% began rheumatology training in Canada. There was a positive relationship at the postgraduate year 1 (PGY1) level between more rheumatology opportunities and chance of entering rheumatology (r(2) = 0.35, p < 0.05), but not at the PGY2 or PGY3 level. Among rheumatology trainees, 78% remained at the training institution where they completed IM training, more than the 70% of gastroenterology trainees, 68% of nephrology trainees, 67% of endocrinology trainees, and 76% of infectious diseases trainees.
CONCLUSION: The opportunity for a rheumatology rotation in the first year of IM training increases the likelihood the trainee may choose rheumatology as a career. Further, most rheumatology trainees continue at the same institution as their IM training, more than other subspecialties. This information may assist recruitment efforts to increase numbers of rheumatology trainees and the overall rheumatology workforce. These data warrant reevaluation of IM programs of study in order to influence trainee career choices and plan better for future workforce requirements in all IM fields.