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Critical shortage of internal medicine MDs foreseen

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Reuters Health

Wednesday, September 10, 2008

WASHINGTON (Reuters) - Only 23 percent of U.S. medical students plan to practice internal medicine and just 2 percent intend to become general practitioners, leading to a possible healthcare crisis, researchers reported on Tuesday.

Students are especially worried about caring for elderly patients with complicated diseases, and are being scared away from becoming the kind of general practitioners that will be most needed in the future, the researchers reported.

The students complained that internal medicine required more paperwork, a greater breadth of knowledge and would pay less than more lucrative specialties.

This could lead to a crisis in healthcare, Dr. Karen Hauer of the University of California, San Francisco, and colleagues reported in the Journal of the American Medical Association.

"The number of older adults in the United States is expected to nearly double between the years 2005 and 2030, and one planning model predicts that the United States will have 200,000 too few physicians by 2020," they wrote.

"Students were dissuaded from internal medicine by their experiences with elderly and chronically ill patients," they added. "Other studies have shown that students' attitudes about caring for elderly and chronically ill patients decline during training."

They polled 1,177 medical students, and found 23 percent planned careers in internal medicine, with just 24 planning to go into general internal medicine.

"Our large sample of U.S. medical students expressed reservations about careers in internal medicine because of patient complexity, the practice environment and the lifestyle compared with other specialties," the researchers wrote.

Perhaps a course in emotional intelligence might help, suggested Daisy Grewal and Heather Davidson of Stanford University in California.

Training in emotional intelligence -- the ability to detect and manage one's own and other people's emotions -- might make for better and happier doctors all around, they wrote in a commentary in the journal.

"Given the importance of interpersonal and communication skills in a variety of outcomes, understanding the skills underlying emotional intelligence competencies is increasingly important," they wrote.

"Emotional intelligence is a concept worth further exploration in medical education and may be one of several important theories that help move the culture of medical education ahead by creating a better learning, working, and caring environment."


Reuters Health

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