Internal Medicine Resident Perceptions of Optimal Training Duration

Abstract

To describe internal medicine residents' opinions regarding the optimal duration of internal medicine residency training, and to assess whether these opinions are associated with specific career interests. A national cohort study was conducted during the 2005 Internal Medicine In-Training Examination (IM-ITE), which involved 382 of 388 (98.5%) U.S. internal medicine programs. A sample of 14,579 residents enrolled in three-year categorical or primary care training programs in the United States reported their opinions regarding optimal residency training duration on the IM-ITE 2005 Residents Questionnaire. Reported optimal training duration was assessed by postgraduate training year, sex, medical school location, program type, and reported career plan. Among the residents surveyed, 78.1% reported a three-year optimal length of internal medicine residency training, 15.3% preferred a two-year training duration, and 6.7% preferred a four-year duration. Residents planning careers in general medicine, hospital medicine, and subspecialty fields all preferred a three-year training duration (83.8%, 82.6%, and 75.9%, respectively). Residents planning subspecialty careers were more likely than those planning general or hospital medicine careers to prefer a two-year program (18.7% versus 7.4% and 8.3%). Residents planning generalist or hospitalist careers were more likely to favor a four-year program (8.9% and 9.1%, respectively) compared with residents planning subspecialty careers (5.4%). Most internal medicine residents endorse a three-year optimal duration of internal medicine residency training. This perspective should be considered in further national discussions regarding the optimal duration of internal medicine training.