Restructuring an internal medicine residency program to meet regional and national needs for general internists.

The Department of Medicine at the University of Washington has reorganized its residency program to increase the emphasis on general internal medicine and primary care. New teaching services in community hospitals have been established, clinical training sites in Montana, Idaho and Eastern Washington opened, and primary care residency tracks begun. Current data indicate that a major shift in the career plans of our new residents also has occurred. Whereas a decade ago approximately two thirds of our residents were becoming subspecialists, almost two thirds of our 1979 and 1980 program graduates are headed towards careers as general internists. Many will practice in the region's smaller cities and towns. The program serves as a model for the development of a regional program for graduate training in internal medicine.