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General Internal Medicine

Thomas L. Delbanco, MD
JAMA. 1987;258(16):2245-2247. doi:10.1001/jama.1987.03400160099022.
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General internists have been applying principles of clinical epidemiology and decision theory in clinical investigations,1-4 and the resulting data are both stimulating and confusing to health professionals and patients alike. At the same time, fewer students are heading into internal medicine. This has prompted academe to reevaluate undergraduate and graduate medical education programs in internal medicine, with many suggesting that rapid changes on the hospital ward reinforce the physician's office as the focus for education. This not-so-quiet revolution is bringing clinical epidemiology, decision analysis, and medical ethics to the center of the stage, with particular focus on patient preferences (utilities) and shared patientphysician decision making.

In the most recent National Residency Matching Program, some of the most prestigious training programs in internal medicine found themselves with open positions. Why fewer students are choosing internal medicine is not altogether clear. In part, medical students may be choosing other specialties because

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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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