The existing pattern for training physicians for specialty practice following medical school and internship is a relatively modern development. While many hospitals had resident medical officers during the 19th century, apparently the first residency system in its modern sense was established by Halsted at the Johns Hopkins Hospital in 1890.1 The first listing of residencies in The Journal did not appear until 1927. At that time there were 1,776 positions offered.
Table 1 shows the growth of such programs in relation to the numbers of medical schools, medical graduates, internships offered, and residencies offered for selected years. These figures emphasize the modernity of residency programs and demonstrate certain landmarks and trends in the education of physicians. The major points of interest are perhaps the following:
The sharp decline in the number of medical schools and graduates between 1905 and 1920—reflecting the revolution in medical education resulting in the