Internal medicine in the National Resident Matching Program 1987: the ides of March.

The number and percentage of graduating seniors from medical schools in the United States who have matched to categorical programs in internal medicine in the National Resident Matching Program have decreased since 1985. Examination of the balance between undergraduate and graduate medical education in the 127 networks of each medical school in the United States and its associated hospitals showed major differences in the retention and recruitment of graduates. The service needs of hospitals rather than the number of graduates from schools in the United States would seem to have controlled the number of positions. Because the positions exceeding the number of graduates from the United States are filled by graduates of foreign schools, these positions are of major importance in determining the supply of internists. The clerkship programs must be restructured to provide students an improved introduction to internal medicine, and the number of entering positions in residencies must be reduced by the substitution of other personnel to do some of the service functions now done by residents.