Primary care residents should train more outside the hospital setting

LETTER — Posted April 11, 2005

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Regarding "Illinois lawsuit could further restrict resident work hours" (Article, March 21): On the 80-hour workweek for residents, I feel that the biggest problem in internal medicine residencies is that the training for primary care and urgent care is extremely poor.

When I graduated residency, I was well trained as a hospital physician. This is because the academic medical centers need residents to take call. But most internal medicine residents are poorly trained for the primary care world that may lay ahead.

My solution would be for the third year of residency to be broken down between residents planning on specialties and those doing primary care. Those entering specialties would train in the traditional hospital manner. Those interested in primary care would spend at least five half-days a week in their own clinic or in an urgent-care setting. Internal medicine has failed its graduates in preparing them for a primary care career.

Shailesh Bhat, MD, Woodland Hills, Calif.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/04/11/edlt0411.htm.

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