Specialization And The Physician Workforce

The document from 23 years ago discussed the imbalance between generalists and specialists in the physician workforce and suggested reforms in U.S. graduate medical education. It referenced a 1994 proposal by Fogelman to stop training subspecialists, except for those pursuing academic or research roles, and to extend general internal medicine residency by a year to include training in subspecialties and procedures, with guaranteed faculty positions for completers. The document advocated for further experiments tied to patient outcomes and emphasized that health care system changes, including the physician workforce composition, should prioritize patient and population needs over the profession's needs.