Academic medicine : journal of the Association of American Medical Colleges
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To increase the number of residents choosing to practice in rural and underserved areas, the Medical College of Georgia in 1994 created the Office of Recruitment and Retention (ORR) for generalist physicians as part of its participation in The Robert Wood Johnson Foundation's Generalist Physician Initiative. Its major purpose is to increase the contact between generalist residents and practice opportunities, especially those in rural and underserved areas. The office has helped residents better understand the resources available in rural settings and has helped these communities better understand the needs of graduates in generalist residency programs. ⋯ The office organized practice management sessions and provided legal consultation to residents desiring to enter private practice in rural settings. This program has already been instrumental in furthering contact between generalist residents and the rural communities they selected as clinical practice sites during training. Although it is too early to know the impact of these activities, communities increasingly use the office to recruit generalist physicians, and residents use it to identify appropriate practice sites.
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Comparative Study
Caring for the chronically ill: a vital subject for medical education.
The growing prevalence of chronic illness will be the predominant challenge to the American health care system in the coming century. Patients with chronic conditions account for three fourths of U. ⋯ Despite the enormity of this problem, the management of chronic illness has received little attention in undergraduate and graduate medical education. This paper describes the competencies required to develop curricula in the management of chronic illness.
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The authors assembled a compendium of programs world-wide that are dedicated to teaching individuals how to direct, research, or improve the education of health professionals. To accomplish this task, in 1996 and 1997 they interviewed and corresponded with researchers in the health professions and with staffs of faculty development fellowship programs listed in the 1966 Fellowship Directory for Family Physicians, and consulted several postings on the DR-ED listserv. To be included in the compendium, the program had to be specifically focused on health professions education. ⋯ The majority had flexible study-time arrangements. Graduates of such courses have already assumed leadership position in health professions education and research around the world. The authors hope that their compendium of programs will help guide health professionals who seek to improve their skills in health professions education.
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The corporate transformation of medicine raises questions about the basic purposes and values of the profession and the physician's social role that have not been adequately considered in medical school and residency curricula. Medical schools and graduate programs need to make students and trainees more aware of the conflict between traditional professional values and the imperatives of the market, so they will be better prepared to defend these values in the new business climate. Otherwise, medical schools and teaching hospitals could simply become trade schools, turning out sophisticated technicians, future entrepreneurs, and managers. ⋯ The author concludes that to prevent medicine from becoming merely a technologic business, the medical profession will have to become more actively involved with other policymakers and representatives of the public in efforts to improve the health care system, while preserving professional and social values. To do this, physicians will need a better knowledge of the health care system and its problems than most of them possess. This is a challenge medical educators must now address.