I was standing at the podium speaking to an auditorium full of medical students, many of them wearing their white coats for the first time, as they celebrated accomplishing the first step of their medical education. I had returned from our annual meeting (#SGIM22) and was giving the keynote address for a white coat ceremony in Philadelphia, and during the address, I looked over the audience and noted the extraordinary feeling of pride emanating from the parents in attendance. From a distance, it appeared that each person wearing a short white coat was enthusiastic about the ceremony and I briefly thought to myself… “I wonder how many of them will hold on to their optimism?”
Over the past several years, I’ve heard about a declining interest among students and residents in general internal medicine. Numerous reports exist of a burgeoning crisis in the physician workforce and the worsening shortage primary care doctors that will be critical in improving the life expectancy in much of our nation’s aging population.1 I am not alone in hearing concerns about the lack of growth of in our discipline. Recently, SGIM leaders had the opportunity to meet with colleagues from the American College of Physicians (ACP), Society of Hospital Medicine (SHM), and the Alliance for Academic Internal Medicine (AAIM). During that meeting, we spent significant time discussing our views on the future of internal medicine and how, over the next year, our societies can work together to address common concerns. One key area of focus was about promoting general internal medicine as a career for physicians and how to prepare to next generation of academic internists. One key to successful preparation will be a re-examination of how we educate students, residents, and peer physicians as the climate in medicine continues to evolve at a rapid pace. Another key will be to demonstrate the wide diversity of career paths available to general internal medicine physicians and to provide guidance about those paths may be pursued.
Since the start of the pandemic, we’ve seen significant transformation in the way that care is delivered. The proliferation of virtual ambulatory visits has been striking, yet significant concerns about equity in access to high quality care remain.2 Additionally, the proliferation of medical misinformation, occasionally spread by fellow physicians, may lead to further mistrust of our profession. We must discern fact from fiction for our patients, and it’s important that we continue to develop the skill sets of our fellow physicians and trainees to provide evidence-based information in an easily digestible manner.
In my first column for the Forum,3 I discussed the need to focus on educating the next generation of general internal medicine physicians who: 1) have more limited exposure to the broad array of disease due to disruptions during their clinical training, 2) have an increasing scope of virtual medicine in their practice and 3) seek a greater understanding of how to address the social vulnerabilities of the patients they serve. I am happy to see that for this issue, we received a significant number of submissions answering that call. I am proud to see the large number of our members who are thoughtfully approaching the need to evolve our existing educational processes. I can also report that, in preparation for our next annual meeting (#SGIM23), we are developing a slate of plenary speakers, workshops and symposia focused on creating a forum for Physician-Educators to engage across generations in creating mechanisms to promote interest in general internal medicine.
As I reflect on my question about sustaining optimism among future physicians, emphasizing the ways in which general internists are leading in a myriad of ways (policy, administration, education, and research) is critically important. I believe strongly, based on the submissions we’ve seen for the Forum and for content to our national meeting, the members of our society are the right models to promote improvements in how we train, and I remain excited about the year ahead.