The National Study of Internal Medicine Manpower: XX. The changing demographics of internal medicine residency training programs.

Three annual physician workforce surveys of internal medicine residency programs from 1990-1991, 1991-1992, and 1992-1993 show that changes in the demographic characteristics of internal medicine residents detected in the period 1986-1989 have been sustained; specifically, more women and international medical graduates are entering internal medicine. Women and international medical graduates now compose 32% and 36% of internal medicine trainees, respectively. The percentage of U.S. medical graduates was lower in traditional 3-year (categorical) tracks (64%) and highest in preliminary tracks (1 year of internal medicine leading to another specialty) (87%). Approximately 1500 more first-year residents than positions offered through the National Residency Matching Program were reported in 1992-1993. This suggests that many programs concentrate their recruiting efforts outside the Matching Program. The data also show a continuing high subspecialization rate for residents who complete 3 years of training in internal medicine (approximately 60%), although about one third do not go directly into subspecialty training. We discuss the implications of these findings for the national goal of increasing the number of primary care physicians.