“I’m spending the majority of my efforts these days pursuing faculty recruitment…”

So began a GIM Connect message from Eric Rosenberg, (GIM Division Chief at the University of Florida) in November 2022—it described his struggle recruiting residents into their academic practice despite all things they had done to make practicing there easier and more attractive. Primary care recruitment, he noted, was more difficult than hospital medicine positions, especially now that they were competing with community practices where full-time work was now three days a week of patient care, “with no homework.”

Eric’s message opened the floodgates. Over the next week, dozens of people responded describing their own struggles to recruit as well as their anxieties about what this means for the future of academic GIM in general, and primary care especially. The responses were wide-ranging. Some people contributed steps they have taken in their divisions to increase their success at recruiting new faculty and retaining the ones they already have.  Others spoke to root causes and offered theories about how we could reverse the slow decline of residents entering primary care. Sprinkled in between were numerous offers of empathy and various versions of “I feel your pain.” Eric’s message had clearly hit a nerve.

Fortunately, the conversation began just days before our annual summit in Arizona. While the meeting did not have time set aside for this topic, it surfaced frequently during and around the meeting. We devoted much of our ALGIM Executive Committee meeting to thinking through what we can and should do as an organization to address these widely shared concerns. I’m glad to say that we’ve settled on an answer.

Part of this year’s Hess Institute focused on developing an action plan for addressing this growing crisis. We contracted with Civic Canopy, a Denver-based non-profit organization that specializes in facilitation, to help us develop such a plan. In the weeks leading up to Hess, the ACLGIM Executive Committee worked with Civic Canopy to lay the groundwork for the meeting itself. Surveys were sent to the ACLGIM membership in advance of the meeting to help guide our discussions—I thank those of you who filled them out. As this article goes to press, we are working to develop an action plan and toolkit to help us all with this shared struggle.

This is a challenge that requires a diverse set of perspectives. The usual broad mix of Hess attendees, current students, residents, new faculty, and those who have been doing this a long while, have put their experience and creativity to work to help us develop something impactful. In addition to the time devoted to the future of academic GIM described earlier, we had a terrific program, with several stimulating speakers and opportunities for networking and skills building.

Thanks to everyone who contributed to this work—those who attended Hess and the rest of you who offered your thoughts about the nature of our challenges and potential solutions. Stay tuned. I’m optimistic we will have an impactful set of actionable strategies to share with you soon.



ACLGIM, Advocacy, Career Development, Hospital-based Medicine, Leadership, Administration, & Career Planning, Medical Education

Author Descriptions

Dr. Earnest (mark.earnest@cuanschutz.edu) is the Meiklejohn Professor of Medicine and GIM Division Head at the University of Colorado School of Medicine in Aurora, Colorado