Federally supported primary care training programs and pediatric careers.

Abstract

Since the mid-1970s, the federal government has supported residencies in general pediatrics, family practice, and general internal medicine, under Title VII of the Public Health Services Act. The need for continued targeted federal support for primary care has been questioned by those who predict that a physician surplus will produce the needed number of primary care providers without special programs. At a time of federal deficits and budget cutting, funding for all graduate medical education is under review, but primary care programs are especially vulnerable since these programs do not automatically command a large academic or political constituency. Before deciding to abandon targeted programs, it seemed reasonable to examine whether they had achieved the stated government goals. For example, the original Public Health Service legislation encouraged the production of generalists, as opposed to specialists. Representatives of family practice and general internal medicine have reported that graduates in these specialties have