Holt Kathleen D, Miller Rebecca S, Philibert Ingrid, Nasca Thomas J
J Grad Med Educ. 2014 Jun;6(2):399-403. doi: 10.4300/JGME-D-14-00140.1.
Recent studies suggest that the supply of primary care physicians and generalist physicians in other specialties may be inadequate to meet the needs of the US population. Data on the numbers and types of physicians-in-training, such as those collected by the Accreditation Council for Graduate Medical Education (ACGME), can be used to help understand variables affecting this supply.
We assessed trends in the number and type of medical school graduates entering accredited residencies, and the impact those trends could have on the future physician workforce.
Since 2004, the ACGME has published annually its data on accredited institutions, programs, and residents to help the graduate medical education community understand major trends in residency education, and to help guide graduate medical education policy. We present key results and trends for the period between academic years 2003-2004 and 2012-2013.
The data show that increases in trainees in accredited programs are not uniform across specialties, or the types of medical school from which trainees graduated. In the past 10 years, the growth in residents entering training that culminates in initial board certification ("pipeline" specialties) was 13.0%, the number of trainees entering subspecialty education increased 39.9%. In the past 5 years, there has been a 25.8% increase in the number of osteopathic physicians entering allopathic programs.
These trends portend challenges in absorbing the increasing numbers of allopathic and osteopathic graduates, and US international graduates in accredited programs. The increasing trend in subspecialization appears at odds with the current understanding of the need for generalist physicians.
近期研究表明，初级保健医生以及其他专科的全科医生供应可能不足以满足美国人口的需求。研究生医学教育认证委员会（ACGME）收集的有关培训医师数量和类型的数据，可用于帮助了解影响这一供应的变量。
我们评估了进入经认可的住院医师培训项目的医学院毕业生数量和类型的趋势，以及这些趋势对未来医师队伍可能产生的影响。
自2004年以来，ACGME每年都会公布其关于经认可的机构、项目和住院医师的数据，以帮助研究生医学教育界了解住院医师培训教育的主要趋势，并指导研究生医学教育政策。我们展示了2003 - 2004学年至2012 - 2013学年期间的关键结果和趋势。
数据显示，经认可项目中的学员增长在各专科之间以及学员毕业的医学院类型之间并不统一。在过去10年中，最终获得初始委员会认证的住院医师培训学员（“渠道”专科）增长了13.0%，进入亚专科教育的学员数量增长了39.9%。在过去5年中，进入对抗疗法项目的整骨疗法医生数量增加了25.8%。
这些趋势预示着在吸纳越来越多的对抗疗法和整骨疗法毕业生以及美国国际毕业生进入经认可项目方面存在挑战。亚专科化的增长趋势似乎与目前对全科医生需求的认识不一致。
