According to a Medical News Today article, doctors with training in internal medicine are unprepared for primary care positions. Research shows that medical training focuses too much on inpatient care and not enough on outpatient care, “the bread and butter of any physician.” (90% of doctor visits are outpatient visits.)
This means that residents graduate knowing more about how to work a ventilator, for example, than they do about how to care for patients with straightforward chronic conditions like hypertension, diabetes, and high cholesterol.
At a time when primary care physicians are in high demand, and as the population ages, doctors need to have a greater handle on how to manage chronic diseases. Another study shows that patients who see good internists generally cost less to treat and spend less time in the hospital.
“We need to change the way we teach residents,” says general internist Stephen Sisson, an associate professor of medicine at the Johns Hopkins University School of Medicine. “If the mission of internal medicine residency programs is to meet society’s health care needs, then our results suggest that these training programs are failing.”
Sisson’s research suggests that there is a “drop-off in learning” between the second and third years of residency, probably due to residents pursing fellowships in specialty fields. He also notes that residents in community hospitals test better in internal medicine knowledge and are more likely to go into primary care.
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