Graduate medical education. Its impact on specialty distribution.

A model was developed that describes the flow of residents through the graduate medical education (GME) system (derived from anonymous GME histories of the 160,000 US medical school graduates [1960 to 1977] on the American Medical Association's physician's master file in 1979). The model showed ultimate specialty distribution among practitioners as a function of specialty distribution among residents at entry to GME indicating that an increase in family practice residents will probably yield an increase in primary care practitioners, owing to the lower level of attrition from family practice residencies as opposed to specialists in internal medicine and pediatrics. Increases in first-year family medicine residencies led to decreases in primary care residencies as a whole led to increases in internal medicine subspecialists but to decreases in surgical subspecialists.