High quality care and teaching in a nursing home require organization of an active medical staff that enhances and does not distract from a physician's commitment to his practice in the office and hospital. The medical residency program at the Jewish Home for the Elderly of Fairfield, Connecticut, is described. (MLW)

A format was devised for nursing home rounds that provides for discussion among staff members and specialists and is aimed at teaching and the resolution of specific patient-care and administrative issues. Many complex medical problems were handled without transferring the patients to an acute-care facility. (Author/MLW)

Evidence is presented to support the development of the nursing home as a required clinical educational site. Analogies and differences between the nursing home and the hospital in medical education are explored as a means of understanding the potential and limits of the nursing home's role in medical education. (Author/MLW)