Residencies in Clinical and Preventive Medicine

Abstract

After 80 years, US training for clinical specialties is essentially hospital-based supervised practice. Needs for specialists are barely met, particularly since one third of residents are foreign citizens. Training must be more efficient, shorter, and relevant to community practice. Numbers of trainees in preventive medicine are entirely inadequate. Residencies have grown rapidly, but comprise only 1% of programs and positions. Younger physicians are recruited through community impact on health care, students, and teachers. These preventive medicine residents function outside hospitals, work fewer hours, are paid more than clinical residents, and obtain an academic year’s graduate education. They work fewer hours, but receive less pay than clinicians. The nation must examine the concept of training physicians for nonclinical preventive medicine functions and, if training continues, must develop methods of making training and career more attractive.