#pcp15 | The Challenge: Internal Medicine Training The Challenge: Internal Medicine TrainingThis year's A. G. Sison Lecture featured Dr. David Fleming, the presidentof the American College of Physicians, to discuss the future of InternalMedicine training and practice. He provided an overview of the process andintricacies of the Internal Medicine training programs in the United Statesand Europe. In his presentation, he mentioned the report of Dr. Kirch lastMarch 2015 that the shortage of primary care physicians is significant andthat the supply of physicians is estimated to be inadequate to meet thequality medical care the aging population will need. He identified severalfactors that has contributed to the declining supply of internists namely,cost of education, workload and stress, complexity of patients, changingpractice environment, and dissatisfied mentors and physicians in practice.An important factor he mentioned are the debts a physician incurs as onecontinues his journey to become an internist. He likewise mentioned theimportance of ambulatory care and emphasized the need to continuously honeour clinical and diagnostic skills, in addition to the core skills we havebeen taught in medical school. He pointed out the improtance of developinggood clinical habits and improving skills including thorough physicalexamination early in training so that one could develop a solid foundationof the fundamentals. The lecture by Dr. Fleming wil surely help and guidephysicians, especially those in training and about to begin their practice.We may be a little behind resources-wise as compared to our westerncounterparts, however the challenges he presented are also widelyencountered in our setting. May his lecture help us overcome the manychallenges we have ahead as we continue to strive to be the internists wehave always aspired to be. - Kristianne Medina, MD