Changes in the internal medicine internship from 1967 to 1987: explanations for decreasing interest in the discipline?

We compared the schedules and responsibilities of medical interns at an urban university hospital in 1967 with those in 1987. We analyzed admissions, length of stay, diagnostic problems, demographic data on interns, changes in diagnostic and therapeutic options, and number and type of consultations. The intern in 1987 spent less time in the hospital but had more admissions, more interruptions, more clerical responsibilities, and more therapeutic and diagnostic options, and was more dependent on senior colleagues with special expertise. For these reasons the intern in 1987 had less time with individual patients and less autonomy than his 1967 counterpart. Recognition and modification of the negative aspects of medicine interns' experience will increase the attractiveness of internal medicine residencies.