Training for internal medicine.

I read with amusement the proposal to increase by one year the training for internal medicine specialists. Does everybody today want to be known as having a “special skill”? I submit that if residents who complete four years of training in internal medicine find themselves lacking skills, it is the training that is deficient, not the time spent training. Four years is a substantial amount of time and clearly should suffice for becoming a general internist — of which, incidentally, we have too few. Most residents subspecialize and then, over time, lose the skills necessary to view the patient as a whole. Increasing training by one year will do very little to address a deficient program or the shortage of general internists. It merely keeps students in school for one more unnecessary year.