Delivering on the Promise: Exploring Training Characteristics and Graduate Career Pursuits of Primary Care Internal Medicine Residency Programs and Tracks

ABSTRACT Background Specialized primary care internal medicine (PC IM) residency programs and tracks aim to provide dedicated PC training. How programs deliver this is unclear. Objective We explored how PC IM programs and tracks provide ambulatory training. Methods We conducted a cross-sectional survey from 2012 to 2013 of PC IM program and track leaders via a search of national databases and program websites. We reported PC IM curricular content, clinical experiences, and graduate career pursuits, and assessed correlation between career pursuits and curricular content and clinical experiences. Results Forty-five of 70 (64%) identified PC IM programs and tracks completed the survey. PC IM programs provide a breadth of curricular content and clinical experiences, including a mean 22.8 weeks ambulatory training and a mean 69.4 continuity clinics per year. Of PC IM graduates within 5 years, 55.8% pursue PC or general internal medicine (GIM) careers and 23.1% pursue traditional subspecialty fellowship training. Curricular content and clinical experiences correlate weakly with career choices. PC IM graduates pursuing PC or GIM careers correlated with ambulatory rotation in women's health (correlation coefficient [rho] = 0.36, P = .034) and mental health (rho = 0.38, P = .023) and curricular content in teaching and medical education (rho = 0.35, P = .035). PC IM graduates pursuing subspecialty fellowship negatively correlated with curricular content in leadership and teams (rho = -0.48, P = .003) and ambulatory training time (rho = -0.38, P = .024). Conclusions PC IM programs and tracks largely deliver on the promise to provide PC training and education and produce graduates engaged in PC and GIM.

Neurologist at ringside-to be or not to be?

Background: Ringside physicians are entrusted with the task of protecting the health and safety of combat sports (boxing and mixed martial arts) athletes. Ringside physicians come from various disciplines of medicine such as primary care, Internal Medicine, orthopaedics, sports medicine and even otolaryngology. There are very few neurologists who work as ringside physicians. Discussion: Boxing and MMA are highly controversial sports for neurologists to be involved in for in these sports every punch and kick to the head is thrown with the intention of knocking the opponent out. Every punch and kick to the head is thrown with the intention to win via causing a concussion. Many neurologists thus feel it is unethical to support boxing by working as a ringside physician. Conclusion: Boxing and MMA are universally thought to be detrimental to the brain and nearly all medical associations at various times have made calls to ban boxing and MMA altogether. While medical associations and physicians including neurologists may not support boxing or MMA, the presence of a neurologist ringside or cageside helps make these sports safer by protecting the health and safety of a combat sports athlete.

Neurologist at ringside-to be or not to be?

Background: Ringside physicians are entrusted with the task of protecting the health and safety of combat sports (boxing and mixed martial arts) athletes. Ringside physicians come from various disciplines of medicine such as primary care, Internal Medicine, orthopaedics, sports medicine and even otolaryngology. There are very few neurologists who work as ringside physicians. Discussion: Boxing and MMA are highly controversial sports for neurologists to be involved in for in these sports every punch and kick to the head is thrown with the intention of knocking the opponent out. Every punch and kick to the head is thrown with the intention to win via causing a concussion. Many neurologists thus feel it is unethical to support boxing by working as a ringside physician. Conclusion: Boxing and MMA are universally thought to be detrimental to the brain and nearly all medical associations at various times have made calls to ban boxing and MMA altogether. While medical associations and physicians including neurologists may not support boxing or MMA, the presence of a neurologist ringside or cageside helps make these sports safer by protecting the health and safety of a combat sports athlete.