Literature relating to continuity of medical care, including efforts to teach it to medical students is reviewed, and a University of Washington family medicine preceptorship for teaching continuity is described. An evaluation of the program, which places students with physicians so they can follow the care of a family, is presented. (Author/JMD)

The history, status, problems, and prospects of postgraduate medical training for primary care practice in the United Kingdom are reviewed in order to provide insight for American medical educators. The British emphasis on hospital-based training is questioned, but is seen as less of a problem for Americans. (Author/JMD)

A discussion of the influence of finances on students' decisions to enter medicine or pursue low-paying careers in primary care or clinical investigation looks at three factors: medical school costs, the magnitude of student indebtedness, and the effects of indebtedness on career choice. (Author/MSE)

This paper outlines forces that are intensifying change in health care delivery and describes institutional obstacles preventing medical schools' adjustment of their educational offerings. Health professions education institutions are urged to develop centers for determining regional and local workforce needs and subsequently establish regionally…

The primary care clerkship at George Washington University (District of Columbia) medical school, the only required ambulatory care experience in the curriculum, is described. Topics discussed include the interdisciplinary structure of the program, its goals, curriculum and student evaluation, and challenges faced in implementation (faculty,…

The electives program at the University of Missouri at Kansas City School of Medicine was evaluated. The program provides opportunities for learning in community hospitals, physicians' offices and clinics, the main campus of the university, and other health-resources locations in western Missouri. The School of Medicine emphasizes primary care in…

The key element in a clerkship in family practice at Community Hospital, Santa Rosa, California, is the student's General Medical Clinic. Under the supervision of a family physician teacher, senior medical students work as a team with family nurse practitioners caring for patients. (Author/JMD)

A primary care preceptorship was successfully incorporated into the University of Michigan medical school's third-year curriculum. Key components included agreement across primary care specialties on goals and objectives, involvement of community practitioners, frequent communication with preceptors, active feedback to preceptors, and thorough…

The West Virginia School of Osteopathic Medicine's success in educating and retaining primary care physicians for practice in rural Appalachia is ascribed to its focused mission; a multistate student exchange program; careful recruitment, admission, and placement; early clinical training in rural sites; and status as a state-supported institution.…

Traces academic medicine's historical opposition to community medicine and its emphasis on traditional hospital-cased curricula subspecialties, to the neglect of primary and preventive care, community-oriented medicine, and public health. Calls for reducing barriers to basic medical services for all, and for training physicians equipped to respond…

A questionnaire was administered to 339 graduating senior medical students at the Medical College of Georgia to determine different potential sources of influence on career choice. Indebtedness may be associated with the choice of a non-primary care specialty with greater remuneration than primary care specialty. (MLW)

Three models of strategic management for academic health centers are detailed: the traditional model, which will become rare; a revised traditional model that offers "boutique" clinical services, biomedical research, and medical education; and the academic services model, focusing on competitive primary and secondary clinical services, health…

Introduction: Tremendous advances in health care have been made through the development of evidence-based medicine (EBM). Studies show that physicians face barriers in practice, preventing the effective use of the best evidence available. Insight into these barriers should pave the way for an action plan to remove them. The aim of this study was…

Community Health Aides and Community Health Practitioners (CHA/Ps), the primary providers of healthcare in rural Alaska, share the importance of story as a culturally respectful way for creating meaning and broadening understanding. Story is woven into the fabric of cancer education courses for CHA/Ps. Between May 2004 and April 2007, 13 week-long…

This paper explores the results of an experimental program at Tufts University designed to affect medical students' career choices. Students were located in a rural hospital for the entire third year of their medical training. It was hypothesized that the program would result in more positive orientations toward practice in rural settings and…