In Reply: We agree with Dr Kaufman that residents
should ideally be prepared to manage all the professional issues they are
likely to encounter, including the organizational, policy-related and business
aspects of practice in our tumultuous health care system. Our survey did,
in fact, inquire about residents' preparedness to participate in certain of
these activities. Because of inherent limitations to the length of surveys,
we could not cover these matters in the detail we would have liked. Some of
our findings concerning these skills are reported elsewhere.1
Deficits in these nonclinical skills are often substantial. For example, we
found that 40% of third-year internal medicine residents felt unprepared to
participate in quality assurance activities.
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