Many General Internists Leave Field by Mid-Career

One in six leave internal medicine versus one in 25 internal medicine subspecialists, survey finds
By Eric Metcalf
HealthDay Reporter

FRIDAY, May 14 (HealthDay News) -- Roughly one out of six general internists are leaving internal medicine by mid-career, a substantially higher proportion compared to internal medicine subspecialists, according to survey results published April 29 in the Journal of General Internal Medicine.

Wayne H. Bylsma, Ph.D., of the American College of Physicians in Philadelphia, and colleagues analyzed survey data from 2,058 internists who were certified by the American Board of Internal Medicine from 1990 to 1995 in general internal medicine or an internal medicine subspecialty.

The researchers found that 9 percent of all internists were no longer working in general internal medicine or one of its subspecialties roughly a decade after their original certification. Seventeen percent of general internists and 4 percent of subspecialists had left internal medicine. A lower proportion of general internists reported satisfaction with their career compared to subspecialists (70 versus 77 percent).

One explanation "for the greater attrition in general internal medicine than in internal medicine subspecialties is that the 'general' nature of general internal medicine makes it a convenient stepping stone to careers outside of internal medicine and to some non-medical fields," the authors write. "We found that a sizeable minority (40 percent) of internists who have left internal medicine are open to returning. Changes in the practice environment might entice them back to the field."

The study was funded by the American Board of Internal Medicine Foundation and the American College of Physicians Inc., which employs study authors.

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