Document Detail


Overcoming barriers to generalism in medicine: the residents' perspective.
MedLine Citation:
PMID:  7826465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
At a 1993 conference sponsored by the U.S. Bureau of Health Professions, a group of residents in several disciplines discussed barriers to generalism in medicine and ways to overcome them. In medical school, the barriers have to do with the lack of strong generalist mentors and lack of appropriate training in ambulatory generalist practice. In residency programs, the system does not support continuity of care and contains too few generalists as preceptors in clinical settings. The ambulatory clinic's inefficiency reinforces residents' frustrations and disillusionment with primary care practice. Further, the culture of medicine denigrates generalism and gives prestige and respect to subspecialists. In academic medicine, the dichotomy between scientist-physicians and clinician-physicians is a barrier. The public has adopted the perception promulgated by the medical leadership that generalists are less skilled and have less to offer than subspecialists. The residents offered recommendations for medical schools (changes in faculty and administration, curriculum, and financial support), for residency programs (changes in curriculum and structure), for the culture of medicine, and for public awareness. To increase the role of the generalist physicians, academic medicine institutions must pursue systematic, broad-based approaches to overcome barriers to generalist education and practice.
Authors:
E Steiner; J M Stoken
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  70     ISSN:  1040-2446     ISO Abbreviation:  Acad Med     Publication Date:  1995 Jan 
Date Detail:
Created Date:  1995-02-22     Completed Date:  1995-02-22     Revised Date:  2000-12-18    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S89-94     Citation Subset:  AIM; IM    
Affiliation:
Oregon Health Sciences University, Portland.
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MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel
Curriculum
Family Practice / education*,  trends
Forecasting
Internship and Residency* / trends
Mentors
Primary Health Care* / trends
Public Opinion
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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