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September 1977

The General Internist: A Perspective

Author Affiliations

From the Department of Medicine, Reading (Pa) Hospital.

Arch Intern Med. 1977;137(9):1283-1285. doi:10.1001/archinte.1977.03630210139046

Fifteen to 20 years ago, an article such as this, on reorienting the education of the internist, would have seemed redundant. As recently as two or three years ago, the national educational scene for general internal medicine appeared chaotic, and only since that time has some order emerged from chaos.

The history of the last 20 years of medicine and the reasons for the emphasis on subspecialization and research in medicine have frequently been examined. We have seen a decrease in the number of general internists in relation to patient needs, as subspecialists and family physicians grew in numbers. The reasons for these changes have been discussed by many commentators and include the following: the orientation of the National Institutes of Health, the population growth and concomitant work pressures, the loss of role models in teaching hospitals, the preferences of students, the glamour of procedural medicine, economic incentives (procedures vs

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