A national census of internal medicine residency and fellowship training programs was done in 1981 and 1982, a continuation of surveys conducted annually since 1976. The number of residents in training continues to rise in relation to the increasing number of U.S. medical school graduates. U.S. citizens who are graduates of foreign medical schools comprise a rising number of the residents, 11.6% of the first-year trainees in 1982-1983. Foreign-born graduates of foreign medical schools have declined in the last 2 years to 9.9% of all first-year trainees. The number of blacks in residency training remains less than 5% of the trainee population. More than half of the residents entered subspecialty fellowship training after the completion of residency training. This finding predicts a continuing increase in the ratio of subspecialty internists to general internists in the practicing internal medicine population. The implications of these results for public policy are discussed.