Graduate Medical Education and Water in the Soup

When I was an intern in a New York City hospital in the late 1960s, a pay increase for house staff brought our salaries to $4,500 a year. I can remember how my chief of service reacted. “It used to be,” he groused, “that all you needed to hire interns and residents was to put a little more water in the soup.”The days of putting water in the soup are now long behind us, but we have continued to approach house-staff training in the United States in a relatively casual and unplanned fashion. This static state has been made . . .