Objective: A high percentage of suicide victims have seen a primary care physician in the months before committing suicide. Thus, primary care physicians may play an important role in suicide prevention. Method: The authors mailed a survey to directors of training programs in family practice, internal medicine, and pediatrics, and 50.5% responded.…

A study in a medical center investigated the feasibility of primary care practices combining internal medicine and pediatrics residencies. Equally divided among children and adults, the patients had sought specialists and were highly satisfied. The physicians had appeal particularly to young upper-middle class patients. (Author/MSE)

A comparison of patient (n=181) and tutor (n=31) evaluations of medical student (n=41) behavior in an internal medicine clerkship revealed difficulties with patient evaluation of students. The process is time consuming and introduces tension between students and patients, and patients are poor discriminators. (Author/MSE)

A study compared the 1984-88 test performances of United States osteopathic medical school graduates and Canadian medical school graduates with those of U.S. and foreign medical school graduates during the same period. Findings, limitations, and implications for recruitment and training of internal medicine specialists are discussed. (Author/MSE)

An innovative internal medicine clerkship provides a one-month ambulatory care component followed by two months of traditional inpatient experience. Assessment of the changes in student ability to diagnose in a variety of brief cases found knowledge gains in the shorter ambulatory care segment were double those in the longer segment. (MSE)

A study of 184 third-year medical students randomly assigned to ambulatory care and traditional inpatient curricula in an internal medicine clerkship found those with the ambulatory care experience were somewhat more likely to choose an ambulatory care career than those in the traditional curriculum. However, the clerkship experience did not…

A study found that a 50-minute lecture on the value of autopsy had little effect on housestaff patterns of requesting autopsies. Housestaff (n=27) attending the lecture did not request more autopsies or obtain more permissions than did the control group (n=26). Results suggest more sophisticated techniques than lectures should be used. (Author/MSE)

A study examined the relationship between (1) internal medicine patients' total charges and lengths of stay and (2) the degree of autonomy that attending physicians (n=65) permitted their residents (n=40). Results suggest that internal medicine residents have an inherently conservative practice style valuing low-intensity workups and rapid patient…

Comparison of opinions of residents in two programs providing different amounts of geriatric training concerning management of four geriatric and two traditional internal medicine problems found all had less confidence about geriatric than traditional problems. Students with more training offered more support for nondiscriminatory care of elderly…

A survey of 21 internal medicine residencies in New York resulted in identification of 8 essentials of a feasible credentialing protocol, including 5 present in most of the protocols examined. The study produced a master list of procedures with corresponding certification criteria and suggested a uniform credentialing system is possible.…

A trained research assistant used a structured observation form to observe hospital attending rounds, measuring the use of population perspective (risk-factor assessment, prevention, epidemiology, social aspects of illness) during internal medicine case presentations. Results indicated this perspective was raised more frequently when a generalist…

A study investigated the construct validity of three methods for assessing clinical performances of internal medicine clerks: a clinical evaluation form completed by faculty and residents, an objective structured clinical examination, and the National Board of Medical Examiners medicine subject test. Results suggest a significant but…

The University of Cincinnati Department of Internal Medicine instituted a peer review moonlighting committee of residents to design departmental guidelines, document work activities, identify discrepancies, and initiate control policies. Results suggest such a program may help establish mutually acceptable work activity guidelines while…

Although generalist physicians have traditionally been defined by their specialties (family, internal, pediatric medicine), this approach may not recognize specific competencies and training needed. A new definition based on functional requirements of generalist practice and the central role of the generalist in comprehensive care is proposed.…

Analysis of the internal medicine clinical rotations of 43 University of Michigan medical students revealed that students saw many kinds of medical problems but few instances of each and that there were wide gaps in exposure to some typical ambulatory care problems. Student skill gains did not correlate with problem types encountered. (MSE)