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Med School Grads May Not Be Ready for Primary Care
Date:1/14/2011

FRIDAY, Jan. 14 (HealthDay News) -- Internal medicine residents aren't getting the training they need to become primary care doctors, who are expected to be in greater demand as the U.S. population ages, contends a new study from Johns Hopkins.

They're unprepared to care for people with such ongoing health problems as diabetes, hypertension and high cholesterol, the study says, though they may be well-versed in treating someone who's hospitalized.

"When I graduated from residency here, I knew much more about how to ventilate a patient on a machine than how to control somebody's blood sugar -- and that's a problem," Dr. Stephen Sisson, a general internist and associate professor of medicine at the Johns Hopkins University School of Medicine and the study's leader, said in a Hopkins news release.

"The average resident doesn't know what the goal for normal fasting blood sugar should be," Sisson said. "If you don't know what it has to be, how are you going to guide your diabetes management with patients?"

This stems from medical school curriculums that focus on inpatient rather than outpatient care, even though outpatient visits account for 90 percent of all visits with doctors, according to the study.

The researchers did find that doctors who completed internal medicine residency programs at community hospitals were better prepared to handle outpatient needs than were those who had trained at academic medical centers.

For the study, published in the January issue of the American Journal of Medicine, Sisson and his colleagues analyzed the performance of internal medicine residents at 67 U.S. medical residency programs during the 2006-2007 academic year.

"We need to change the way we teach residents," Sisson said. "If the mission of internal medicine residency programs is to meet society's health-care needs, then our results suggest that these training programs are failing."

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