LETTER
Other Approaches to Primary Care Training
Anand B. Mutgi, MD;
Basil E. Akpunonu, MD; and
Douglas J. Federman, MD
15 July 1994 | Volume 121 Issue 2 | Page 153
TO THE EDITOR:
As practicing academic general internists, we believe that the perception of "The Future of Internal Medicine," [1] although provocative, predominantly portrays a doom and gloom situation. The authors advocate a strong but separate identity for general internal medicine to increase recruitment by enhancing its status—a nonintegrated approach. We propose a more integrated approach by shedding the boundaries between general internal medicine, family medicine, and pediatrics.
Why not establish student and residency programs with cross-cultural training? Residents could choose to complete 2 years of internal medicine with either 2 years of family medicine, 2 years of pediatrics, or a combination of both. At the end, they would be eligible for two separate boards. This would prepare residents to cope with many different medical problems in any setting. With 4-year training, physicians would be less inclined to do further subspecialty training, thus limiting subspecialization to physicians genuinely interested in a specific area. Ability to handle complex problems would reduce referrals. Such a program would launch us into the 21st century of medicine with greater flexibility and a clearer definition of the primary care physician's role.
1. Petersdorf RG, Goitein L. The future of internal medicine. Ann Intern Med. 1993; 119:1130-7.
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