Internal medicine residency programs that put increasing emphasis on outpatient experience and continuity of care place demands on residents that conflict with inpatient responsibilities. The development and implementation at the University of Virginia Hospital of a rotational scheduling system aimed at alleviating the conflict is described.…

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…

Examines cultural factors associated with pregnancy among Hispanic adolescents, highlighting policy areas within the health care delivery system that must be addressed. The paper discusses migratory patterns and service needs, acculturation and pregnancy, valuing of children, access to health services, the role of the health practitioner, and…

This study examined self-assessments of 40 medical residents and competence expectations of 4 primary care internal medicine faculty and 10 medical specialty faculty. Specialty faculty members reported higher expectations for diagnostic performance than did faculty in primary care. Involvement of residents and faculty members in developing…

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,…

Early literacy experiences play an important role in later literacy skills and school achievement. Communities offer early literacy experiences in a variety of venues to meet the diverse needs of families. The author of this article provides four vignettes illustrating community-based early literacy activities: (1) private group classes such as…

This paper explores the broad definition of health in the rural context and relates it to policy, practice, and pedagogical challenges in providing access to services in rural areas. Historically, policy, practice, and teaching institutions have supported a dependency model for health service delivery, forcing rural communities to rely on…

This brochure describes the meeting of 63 representatives from the American Academy of Pediatrics, Washington Business Group on Health, Maternal and Child Health Bureau, and the education community convened to develop an action plan for American health care that would be responsive to children's needs. Highlighted problems included the lack of…

Health promotion redirects thinking about health by: reasserting its social and political aspects; ensuring the people the power to define their own health concerns; and placing health more clearly in the context of other aims in life. This compilation of 41 articles in 8 sections attempts to document this process of redirection of thought. The…

Least-cost health strategies designed to attack the world's leading causes of unnecessary death are explored. Section 1 emphasizes the value of primary health-care procedures--midwifery, maternal education on breastfeeding and weaning, vaccinations, oral rehydration of victims of diarrhea, and antibiotics against respiratory infections--in…

Health care and social services in Poland are affected by the culture context of geography, demography, and culturally induced expansion in historical periods. Health and financing of health services are issues with significant political ramifications and, despite egalitarian ideology, there is differential access to care and services. The…

Emphasizing primary care, this handbook focuses on the application of specific types of telecommunications technology to the process of information exchange within a rural health care system. Its purpose is to provide guidance to health care planners who want to consider the potential of telecommunications technology for improving quality,…