Graduate Medical Education Confronted

William A. Hensel, MD
JAMA. 1988;259(18):2695. doi:10.1001/jama.1988.03720180023018.
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To the Editor.  —Dr Perkoff argues convincingly that society should support medical education via taxation and that this support will not happen unless educators meet society's needs by supplying more generalists. Despite the evident social need, Dr Perkoff states that there is no general agreement that graduate medical education should change. To many educators, traditional specialty training is seen as highly effective, while education in the ambulatory setting is viewed as "uninteresting and ineffective."These attitudes are pedantic and destructive to the improvement of medical education. We continue to suffer from the problem that Peabody2 recognized 60 years ago: we are training physicians who "are too 'scientific' and do not know how to take care of patients." Giving students the opportunity to care for ambulatory patients allows them to learn valuable lessons absent from the inpatient experience. A few of these lessons follow:Students need to learn that most


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