Addressing the Primary Care Shortage on a Shoestring: A Successful Track in an Internal Medicine Residency.

Problem: Nationally, shortages of primary care providers are of major concern. Internal medicine programs, once the major supplier of primary care physicians, are no longer producing large numbers of primary care providers to help meet the needs of the growing patient population.

Approach: In 2009, residents at the University of New Mexico created a resident-driven Primary Care Track (PCT) within the internal medicine residency, and after six years this track is thriving. The PCT allows residents to designate blocks of time specifically devoted to primary care training. Residents opt in to the track at the end of intern year and arrange their own schedules over large blocks of time in the last two years of training to allow for an individualized curriculum that prepares them for independent practice in primary care.

Outcomes: Approximately 85% (11/13) of residents who have graduated from the track have gone on to practice in primary care after graduation, and the internal medicine residency program as a whole has also seen an increase in the fraction of residents pursuing primary care since the inception of this track.

Next Steps: The PCT is currently at maximum capacity and may be forced to turn away applicants. To expand while still maintaining the core principles of the track, the PCT will strive to find additional ways to use New Mexico's existing resources and to develop a more robust mentoring structure and didactic programs. Formalized financial, faculty, and administrative support of the program also will be needed.