This article proposes that more leadership is needed in the scientific community to combat inertia in research and education and for progress in higher education and scientific research to occur. This means using new techniques, designing funding mechanisms that promote more adventuresome research, and supporting the independence of creative young…

In the University of South Dakota's medical school clerkship program, students may choose one of three ambulatory-care settings. In one, the curriculum is problem based and student centered to enhance student interest in primary care. The new program has been successful and well received and is being further developed. (MSE)

A popular required family medicine clerkship at Jefferson Medical College (Pennsylvania) suggests that ambulatory care can be taught as a core component of the clinical curriculum. Success requires strong institutional support, structured curriculum, adequate patients, dedicated faculty, sufficient training sites, an appropriate evaluation…

A study of 217 Stanford University (California) Medical School graduates found clerkship experience lengths from 12 to 23 months; the median was 18 months. A highly significant correlation was found between longer clinical training and higher scores on Step 2 of the United States Medical Licensing Examination. Results suggest that decreasing…

The University of Minnesota internal medicine residency program of ambulatory general medicine rotations in rural communities and urban managed care settings is described. Development and structure of rotations, objectives, teaching strategies, faculty development, evaluation system, and elements of successful implementation are discussed.…

The Veterans' Administration new Primary Ambulatory Care and Education (PACE) program at the Sepulveda (California) VA Medical Center, departs from traditional VA medical education models by shifting focus of care from inpatient to outpatient settings. The program uses an interdisciplinary team approach and stresses managed primary care. Aspects…

The University of Cincinnati's comprehensive emergency medicine residency curriculum provides significant practical training in ground and aeromedical transport, disaster work, telemetry communications, and administrative matters. Initial program feedback has been very positive. (MSE)

The University of Pittsburgh School of Medicine's Division of General Internal Medicine is described, focusing on personnel and organization, educational programs, clinical and research activities, special programs, finances, and related issues and pressures. The program is proposed as a model for other institutions. (MSE)

Factors affecting the optimal size of an integrated health care delivery system in an academic medical center are discussed, including: the institution's structure for survival; technology, innovation, and health care costs; and specific characteristics of the institution's education, research, and patient care missions. Several alternative…

The development of medical ethics education at the University of California, San Francisco, is chronicled and its contributions to bioethics literature are noted. Emphasis is placed on the importance of using medical cases in such instruction. The University of Washington's ethics program and its potential for innovation are then described.…

A 1990 survey of 281 health maintenance organizations found 42 were directly involved in graduate medical education, most through agreements with academic medical centers or teaching hospitals, to serve as an ambulatory care rotation site. One-sixth of these were accredited to serve as sponsoring organizations. Program model types were also…

Pennsylvania State University College of Medicine conducts an off-campus retreat for medical residents, in which the instructional focus is on the humanities and particularly difficult medical and ethical issues. Students have found the format beneficial both personally and professionally, valuing involvement of senior faculty, the programs'…

The experiences of three family medicine residency programs in developing and implementing half- to full-day teaching sessions are described. Each program has multiple training locations, including rural sites, and releases residents from clinical duties for sessions on behavior issues, procedures, training, and other topics. Program success…

Data on 180 pediatrics and 302 internal medicine residency training programs concerning vacation, leave of absence, extension of training because of absence, and related policy suggest wide variation depending on postgraduate year of training, discipline, program size, and program type. Implications for accreditation, testing, and certification…

The West Virginia School of Osteopathic Medicine's successful interstate educational exchange program through the Southern Regional Education Board is described, and concerns are expressed for the program's future. Suggestions are offered for establishing similar multistate programs that promote education in medical specialties and encourage…