In response to the perceived need for primary care physicians, two major changes in internal medicine training have occurred: (1) a third year of general training was required for internal medicine board certification and (2) many hospitals developed primary care internal medicine residencies with an increased emphasis on ambulatory training.…

This study attempted to establish the validity of an essay test of clinical judgment by defining the domain of clinical judgment and operationalizing this definition in a 12-item essay examination administered to 98 residents in internal medicine. The relationship between essay scores and other measures of competence was then examined and the…