General Internal Medicine

Abstract

Some 20 years ago, general internal medicine residencies and divisions were organized to move training outside the hospital and to produce a new generation of general internists for primary care. Despite public and private support for such training, the number of general internists from these special programs and from the traditional medical residency programs is fewer today than when this reform began, and the percentage of all primary care practitioners (general internists, family practitioners, and pediatricians) is also lower. These failed manpower outcomes aside, the development of general internal medicine has improved care and learning outside the hospital by other contributions: (1) training curriculums in ambulatory medicine, (2) practitioner-teachers, (3) teaching group practices, and (4) new knowledge about and for practice. The details of these contributions are notable: (1) The curriculum reforms for outpatient training in general internal medicine continue to be adapted for the training of all medical residents;