Report: Reforms for cost of medical education and in payment models still needed

The number of U.S. senior medical students choosing categorical internal medicine residencies increased for the fourth consecutive year. According to the 2013 National Resident Matching Program, 3,135 U.S. medical school seniors matched for residency training in internal medicine, a 6.6 percent increase compared to 2012, when 2,941 matched in internal medicine.

The report also showed a continued increase of U.S. medical graduates who matched in Internal Medicine-Primary Care (200 in 2013, 186 in 2012, and 166 in 2011) and in Med-Peds (increased to 312 in 2013, up from 276 in 2012).

"We are pleased that more U.S. medical students are choosing internal medicine residencies and hope the upward trend continues," said Steven Weinberger, MD, FACP, executive vice president and CEO, American College of Physicians (ACP), the nation's largest medical specialty organization. "However, ACP remains concerned about the need to increase the nation's general internal medicine physician workforce to meet the needs of an aging population requiring care for chronic and complex illnesses and the increased number of individuals who will be receiving coverage through the Affordable Care Act."

The 2013 match for internal medicine is still well below the 3,884 U.S. medical school graduates that chose internal medicine residency programs in 1985.

Categorical internal medicine enrollment numbers decreased from 2007 to 2009 (2,680 in 2007; 2,660 in 2008; and 2,632 in 2009) before increasing in 2010 (2,772) and 2011 (2,940). The great majority of current internal medicine residents will ultimately enter a subspecialty of internal medicine, such as cardiology or gastroenterology. Only about 20 to 25 percent of internal medicine residents eventually choose to specialize in general internal medicine, compared with 54 percent in 1998.

Dr. Weinberger also cited problematic payment models and the exorbitant cost of medical education with the resulting financial burden on medical students and residents as barriers to a career in general internal medicine.

Source: American College of Physicians