Educating General Internists for Kansas

Abstract

Background. The demand for primary care is increasing, yet fewer medical school graduates are entering primary care residencies and fewer residency graduates are targeting their careers toward primary care. The University of Kansas School of Medicine-Wichita (KUSM-W) was created specifically to enrich primary health care in the state. This project examined the impact of the Department of Internal Medicine’s postgraduate education program on the supply of generalist physicians to Kansas. Methods. Residency match data over 19 years were analyzed to determine the number of KUSM-W medical students who matched in internal medicine. Practice setting data for internal medicine and internal medicine/pediatrics residency graduates over 16 years were analyzed to determine type and location of practice. Results. Over 19 years, an average of 20% of KUSM-W medical students matched to an internal medicine residency. A downward trend toward an internal medicine residency was noted over time. Over 16 years, 54% of residency graduates entered primary care practice with the majority staying in Kansas. Twelve percent entered primary care practice in rural communities under 20,000 population. Conclusions. KUSM-W provides a valuable service by graduating a respectable proportion of medical students to internal medicine residencies and a large proportion of residents to primary care practice. Many of the issues that attract students and residents to primary care, however, are not under the direct influence of the medical education system. Changes in health policy, particularly reimbursement and health care delivery issues, will have more impact on primary care workforce than changes in medical education. KJM 2007; 1(1):2-6.