This introduction to a journal supplement on education of the generalist physician describes the supplement's goal of capturing "in a qualitative way, the richness and complexity of primary care education and its place within the much larger context of health care and medical education reform." (JDD)

A study in a medical center investigated the feasibility of primary care practices combining internal medicine and pediatrics residencies. Equally divided among children and adults, the patients had sought specialists and were highly satisfied. The physicians had appeal particularly to young upper-middle class patients. (Author/MSE)

Explored how primary care clinician-teachers actually attempt to convey empathy to medical students and residents. Found that they stress the centrality of role modeling in teaching, and most used debriefing strategies as well as both learner- and patient-centered approaches in instructing learners about empathy. (EV)

In three decades, the osteopathic profession has moved from primarily manipulative therapy to full-service health care, replacing primary care emphasis with specialization. The profession should return to its original mission of primary care, establish links with allopathic medicine, and support new national policy for primary health care.…

A rigorous approach to conducting nonstatistical meta-analyses of research literature is presented and illustrated in a study of literature on primary care medical specialty choice. The approach described includes model development, literature retrieval and coding, quality rating, annotation of high-quality references, and synthesizing the subset…

One reason medical students favor specialization over generalist medicine (primary care) is a perception of generalist medicine as nonrigorous. Chaos science, a new field, reveals an intellectual basis for generalist medicine. The history, strengths, and limits of reductionist thinking in medicine and aspects of chaos theory illuminate this…

To provide medical students in community-based clinical settings with access to the same range of educational resources (medical literature, student colleagues, feedback, faculty) available at the academic medical center, this paper proposes that advancing information technology be applied to create a "virtual clinical campus" in the community…

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…

Medical schools are taking up the challenge to foster interest in the generalist fields. Issues in education of generalist physicians include the need for basic science teaching, more teaching in outpatient settings, difficulties of forecasting workforce needs, the challenge to generalist physician faculty, and the challenge of chronically…

Education of medical students in the basic and clinical sciences must be integrated into a seamless curriculum over four years, team-taught by both a clinician and a basic scientist. Medical students must be able to perform an initial evaluation of a neurological complaint and know when consultation is needed. (Author/MSE)

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)

A survey of 314 medical students before and after a required third-year internal medicine clerkship found differences between students choosing primary care and subspecialties, while undecided students shifted between those groups on several items. Results suggest the clerkship may affect students' image of primary care. (Author/MSE)

Medical student organizations, such as the American Medical Student Association, the Association of American Medical Colleges' Organization of Student Representatives, and the American Academy of Family Physicians' National Congress of Student Members, are responding to the increased need for generalist physicians, through community-based…

A study of factors influencing medical students to choose primary care careers, in contrast with high-technology careers, found students attracted by opportunity to provide direct care, ambulatory care, continuity of care, and involvement in psychosocial aspects of care. Age, race, gender, marital status, and some attitudes were not influential.…

A study of medical students' pre-medical-school and graduation specialty preferences examined sex differences in selection of pediatrics at both points and changes from preference for pediatrics. Half those abandoning early preference for pediatrics stayed within primary care. More shifted from family practice to pediatrics than kept their…