Tinkering or Real Reform? The Choice Is Ours

Article15 June 1992Tinkering or Real Reform? The Choice Is OursJames P. Nolan, MD, Thomas S. Inui, MDJames P. Nolan, MDSearch for more papers by this author, Thomas S. Inui, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-12-1042 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptInternal medicine has been in a dynamic process of change throughout this century (1). Much of the ferment has resulted from new knowledge about disease causes and treatments, development of new technologies, shifts in the settings of care (for example, from office and home to hospital early in this century), and the leadership of notable individuals in internal medicine who established new norms for the discipline and its institutions. A present-day observer could contend that all of these preconditions for change are present again. Additional forces driving the process are the oversupply of specialists and the spiraling costs of health...References1. Beeson P and Maulitz R. The inner history of internal medicine. In: Maulitz RC, Long DE, Wood FC; eds. Grand Rounds: One Hundred Years of Internal Medicine. Philadelphia: University of Pennsylvania Press; 1988:15-54. CrossrefGoogle Scholar2. Schroeder S, Showstack B, and Gerbert B. Residency training in internal medicine: time for a change? Ann Intern Med. 1986;104:554-61. LinkGoogle Scholar3. Halperin A and Kaufman A. Ambulatory medical education: a reconsideration of sites and teachers. J Gen Intern Med. 1990;5(Suppl 1):S35-44. CrossrefMedlineGoogle Scholar4. Noble J. General internal medicine in internal medicine: at the core or on the periphery? Ann Intern Med. 1992;116(12 pt 2):1058-60. LinkGoogle Scholar5. Ende J and Davidoff F. What is a curriculum? Ann Intern Med. 1992;116(12 pt 2):1055-7. LinkGoogle Scholar6. Burke W and Inui T. Do we still need primary care tracks? Ann Intern Med. 1992;116(12 pt 2):1065-70. LinkGoogle Scholar7. Wartman S, O'Sullivan P, and Cyr M. Ambulatory-based residency education: improving the congruence of teaching, learning, and patient care. Ann Intern Med. 1992;116(12 pt 2):1071-5. LinkGoogle Scholar8. Schuster B. The matrix of ambulatory education. Ann Intern Med. 1992;116(12 pt 2):1076-9 LinkGoogle Scholar9. Bennett J. Development of a didactic curriculum in science related to internal medicine. Ann Intern Med. 1992;116(12 pt 2):1088-90. LinkGoogle Scholar10. Wigton R. Training internists in procedural skills. Ann Intern Med. 1992;116(12 pt 2):1091-3. LinkGoogle Scholar11. Nuckolls J. Internal medicine practice in transition: implications for curriculum change. Ann Intern Med. 1992;116(12 pt 2):1051-4. LinkGoogle Scholar12. Fletcher R and Fletcher S. Teaching preventive medicine and health maintenance. Ann Intern Med. 1992;116(12 pt 2):1094-8. LinkGoogle Scholar13. Ebert R and Ginzberg E. The reform of medical education. Health Aff (Millwood). 1988;7(Suppl 2):5-38. CrossrefMedlineGoogle Scholar14. Thompson J, Haist S, DeSimone P, Engelberg J, and Rich E. The accelerated internal medicine program at the University of Kentucky. Ann Intern Med. 1992;116(12 pt 2):1084-7. LinkGoogle Scholar15. Federman D. Relation of the internal medicine residency and the medical school curriculum. Ann Intern Med. 1992;116(12 pt 2):1061-4. LinkGoogle Scholar16. Earley L. Alternative pathways for training the general internist and the medical subspecialist. Ann Intern Med. 1992;116(12 pt 2):1080-3. LinkGoogle Scholar17. Potts J. Recruitment of minority physicians into careers in internal medicine. Ann Intern Med. 1992;116(12 pt 2):1099-1102. LinkGoogle Scholar18. Cohen J. Roles of various organizations in internal medicine curriculum reform. Ann Intern Med. 1992;116(12 pt 2):1111-15. LinkGoogle Scholar19. Benson J. Integrating emerging disciplines. Ann Intern Med. 1992;116(12 pt 2):1106-10. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: James P. Nolan, MD; Thomas S. Inui, MDAffiliations: University of Washington Seattle, WA 98195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAssociations between subspecialty fellowship interest and knowledge of internal medicine: A hypothesis-generating study of internal medicine residentsInadequate training in the biological sciences and medicine for dental studentsRedesigning Residency Education in Internal Medicine: A Position Paper from the Association of Program Directors in Internal MedicineJohn P. Fitzgibbons, MD, Donald R. Bordley, MD, Lee R. Berkowitz, MD, Beth W. Miller, MD, and Mark C. Henderson, MDReforming internal medicine residency trainingConfidence of academic general internists and family physicians to teach ambulatory proceduresThe Dental Curriculum: What Should Be New in the 21st Century?Prevention Training and Medical Residency 15 June 1992Volume 116, Issue 12_Part_2Page: 1042-1045KeywordsHospital medicine ePublished: 1 December 2008 Issue Published: 15 June 1992 Copyright & Permissions© 1992 American College of PhysiciansPDF downloadLoading ...