Dr Zelikoff's observations are correct and the related concerns that he expresses regarding internists' declining role in primary care reflect the concern of leaders of internal medicine whom we interview throughout the country.While Zelikoff's main inference from the article1 is correct, we would like to clarify and supplement his subsequent comments point by point. Since the National Study of Internal Medicine Manpower began collecting data on internal medicine residents in 1976, an increasing proportion of first-year residents in internal medicine have not gone on to the second year in the specialty. However, these are not primarily residents who leave internal medicine but rather those who never made a commitment; they are simply fulfilling the requirement of other Specialty Boards for a first year in internal medicine. Second-year residents are a more accurate predictor of the number of residents interested in internal medicine as a career.Zelikoff
Kohrman CH, Lyttle CS, Andersen RM, Levey GS. Internal Medicine: No Longer a Primary Care Specialty?-Reply. Arch Intern Med. 1991;151(3):616–617. doi:10.1001/archinte.1991.00400030142031
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