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20 June 2006 | Volume 144 Issue 12 | Pages 927-932
The American College of Physicians supports the need for reform throughout the continuum of training in internal medicine. Today's internists must have the necessary knowledge, skills, and attitudes to meet the challenges of an expanding body of medical knowledge and a rapidly evolving system of health care delivery. Suggested priorities for undergraduate medical education include redesigning curricular experiences to afford students earlier and more exposure to career opportunities in internal medicine, improving ambulatory education, exposing students to outstanding faculty role models in internal medicine, and incorporating educational experiences during the fourth year that optimize its value and relevance to the student's future career plans in internal medicine. Internal medicine residency training should remain a 3-year experience, with a component of core education common to all trainees and a component of customized training in the third year targeted toward the resident's career goals. Residency programs should be designed around educational rather than institutional service needs. The ambulatory component of training requires substantial reform in its structure, sites, content, and timing. Team-based models should be used both for patient care and for flexibility in design of residency training. Better faculty models must be developed that build on the concept of a "core faculty," improve the rewards for teaching faculty, and provide appropriate faculty development focusing on a necessary set of educator competencies.
*Members of the Education Committee of the American College of Physicians are Lawrence G. Smith, MD (Chair); Douglas S. Paauw, MD (Vice Chair); Marie T. Brown, MD; Virginia U. Collier, MD; Auguste H. Fortin IV, MD, MPH; Craig S. Kitchens, MD; Kay M. Mitchell, MD; Douglas K. Owens, MD; Henry J. Schultz, MD; Jim Small (medical student); Kevin B. Weiss, MD; and LCDR Patrick E. Young, MC USN. The Board of Regents approved the 2 position papers that served as the basis of this manuscript in October 2005 and January 2006.
Author and Article Information
From the American College of Physicians, Philadelphia, Pennsylvania.
Acknowledgments: The authors thank Drs. F. Daniel Duffy, Christine Cassel, Eric Holmboe, Barbara Turner, and Eric Larson for their helpful comments on the 2 ACP position papers that were synthesized in this manuscript.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Current Author Addresses: Dr. Weinberger: Medical Education and Publishing Division, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Dr. Smith: North Shore–Long Island Jewish Health System, 125 Community Drive, Great Neck, NY 11021.
Dr. Collier: Department of Medicine, Christiana Care Health System, PO Box 6001, Newark, DE 19718. POSITION PAPER
Redesigning Training for Internal Medicine
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