Surveys were mailed to a sample of Michigan internists and family practitioners (N=2060). This study examined influences on (1) how confident physicians feel about treating a particular problem, (2) where they look for assistance and advice, and (3) what level of continued involvement in the patient's care they prefer. (MLW)

Benefits of hospital-based internship and residency programs for training psychologists are discussed, along with issues concerning licensing or certification. In hospitals, interns and residents are exposed to unusual and diverse forms of physical and mental pathology, as well as contact with a diverse patient population crossing all ages, racial…

General practitioners predominate in osteopathic as compared with allopathic medicine, perhaps because of the student selection process, features of osteopathic education, training in osteopathic hospitals, required rotating internship, and more high-quality general practitioner role models. Personality differences may account for differences in…

The experiences of baccalaureate student nurses, from layperson to novice nurse, was studied. Paradigm cases of five senior and five sophomore baccalaureate students were transcribed and analyzed for common meanings and themes. The paradigms concern touching patients, giving shots/creating pain, caring for and being intimate with young patients,…

Medication noncompliance is seen as an obstacle to successful clinical outcomes of many diseases. An exercise for preclinical medical students at Stanford University is described. Objectives include sensitizing students to the consequences of medication noncompliance, illustrating problems, and evaluating a number of compliance-related issues.…

Further work is needed in identifying strategies to improve rural health services that are most appropriate and cost effective in regions with differing circumstances and needs. Substantial reform of payment systems favoring rural and primary care is essential to the effectiveness of educational reform. (Author/MSE)

Discussion of efforts to improve availability of primary health care in rural areas addresses student selection, curriculum, training environment, and special inducements, and controversial areas such as rural training sites, merging of specialties, and compromise of residency continuity. It is proposed that basic institutional philosophical…

Program trainees of an interinstitutional interdisciplinary primary care-mental health training program, implemented in Houston, Texas, included residents in psychiatry, pediatrics, internal medicine, and family practice; medical students; and graduate students in psychology, social work and nursing. A combination of field practicum and didactic…

The large inflow of Foreign Medical Graduates (FMGs) into the U.S. is cited and four issues discussed. They are: (1) the belief that the FMG is less qualified than the U.S. medical graduate and thus contributes to the decline in quality of medical care; (2) the loss of scarce manpower from less developed countries that have greater needs than the…

The Program in Medical Sciences (PIMS) is designed to combine the selection of a heterogeneous class without significant change in the educational environment as designed for a homogeneous class. The program is an attempt to equalize the allocation of resources of the medical profession and to provide primary care physicians to underserved areas.…

A solution to the rural health crisis will require not only changes in student selection, curriculum, and training location but also strengthening of the rural economy, improved reimbursement to rural hospitals and primary care physicians, and increased sensitivity among leaders of the medical profession to rural community and practitioner needs.…

Three factors that will have major effects on the medical cost quality debate are: industrial and governmental policy in regard to health-related expenditures, an aging population, and societal attitudes towards competition in the health care system. Approaches to conflict resolution are offered. (MLW)

Information seeking strategies that primary care physicians use to supplement their knowledge in problem solving were studied to help tailor continuing medical education (CME) courses for various groups of physicians. Of interest were: the sequences physicians use to access different sources, variability among physicians in information search…

The results of a study to identify criteria that could help select applicants to medical school who have a lasting commitment to family medicine are presented. During the past 15 years major efforts have been made to increase the number of family physicians in the United States. Although primary care programs attract more students whose initial…

Medical academic centers must adjust to a period of little or no real economic growth and make changes for continuing progress. Areas affected by the economic slowdown include policies regarding faculty private practice, the relationship between teaching hospitals and academic health centers, the production of primary care physicians, and the…