Family Practice

Robert E. Rakel, MD
JAMA. 1987;258(16):2240-2242. doi:10.1001/jama.1987.03400160094020.
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Sixty years ago, Francis Peabody1 called attention to the trend toward overspecialization and the need to redirect the distribution of physicians into disciplines that more adequately address the needs of society. His plea went unheeded. Similarly, despite the reports of Millis2 and Willard3 in 1966 and the Graduate Medical Education National Advisory Committee4 report in 1980 calling for greater emphasis on training physicians in primary care, no significant change has occurred. As Petersdorf5 observes, graduates continue "to opt for specialty medicine despite the supersaturated state of most specialties." The number of graduates entering general surgery residencies today, for example, is essentially the same as a decade ago, although there is an excess of surgeons.6 In addition, although greater emphasis is being placed on training in geriatrics, Eagleton7 noted that in 1985 five times as many physicians completed fellowships in cardiology as in geriatrics.


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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