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At current levels of training, the supply of generalists will grow substantially and soon exceed several benchmarks for generalist requirements. Since the 1980 report by the Graduate Medical Education National Advisory Committee, 1 there has been increasing concern among policymakers about a physician surplus. In contrast to the prevailing concern about a surplus of specialists, most reform recommendations actually call for an increase in the number of generalists. 2-9 A recent report by the Council of Graduate Medical Education (COGME) 2 predicts a stable per capita generalist supply of about 66 generalists per 100,000 over the next 25 years, which is at the lower end of their estimated requirements of 60 to 80 generalists per 100,000. Recent trends, however, suggest that more physicians are entering primary care fields. 10 Between 1994 and 2000, the total number of trainees in primary care specialties has increased by 10 (if only U.

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