| Where have all the general internists gone? | |
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MedLine Citation:
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PMID: 20429041 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: A shortage of primary care physicians is expected, due in part to decreasing numbers of physicians entering general internal medicine (GIM). Practicing general internists may contribute to the shortage by leaving internal medicine (IM) for other careers in and out of medicine. OBJECTIVE: To better understand mid-career attrition in IM. DESIGN AND PARTICIPANTS: Mail survey to a national sample of internists originally certified by the American Board of Internal Medicine in GIM or an IM subspecialty during the years 1990 to 1995. MAIN MEASURES: Self-reported current status as working in IM, working in another medical or non-medical field, not currently working but plan to return, or retired; and career satisfaction. KEY RESULTS: Nine percent of all internists in the 1990-1995 certification cohorts and a significantly larger proportion of general internists (17%) than IM subspecialists [(4%) P < 0.001] had left IM at mid career. A significantly lower proportion of general internists (70%) than IM subspecialists [(77%) (P < 0.008)] were satisfied with their career. The proportion of general internists who had left IM in 2006 (19%) was not significantly different from the 21% who left in 2004 (P = 0.45). The proportion of general internists who left IM was not significantly different in earlier (1990-92; 19%) versus later (1993-95; 15%) certification cohorts (P = 0.15). CONCLUSIONS: About one in six general internists leave IM by mid-career compared to one in 25 IM subspecialists. Although research finds that doctors leave medicine because of dissatisfaction, this study was inconclusive about whether general internists left IM in greater proportion than IM subspecialists for this reason. A more likely explanation is that GIM serves as a stepping stone to careers outside of IM. |
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Authors:
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Wayne H Bylsma; Gerald K Arnold; Gregory S Fortna; Rebecca S Lipner |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-04-29 |
Journal Detail:
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Title: Journal of general internal medicine Volume: 25 ISSN: 1525-1497 ISO Abbreviation: J Gen Intern Med Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-21 Completed Date: 2011-08-16 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 8605834 Medline TA: J Gen Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 1020-3 Citation Subset: IM |
Affiliation:
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American College of Physicians, Philadelphia, PA 19106, USA. wbylsma@acponline.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Career Choice* Cohort Studies Data Collection / methods Female General Practitioners / trends* Humans Internal Medicine / trends* Male Medicine / trends* Middle Aged |
| Comments/Corrections | |
Comment In:
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J Gen Intern Med. 2010 Oct;25(10):998-9
[PMID:
20697968
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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