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In the conduct of programs of graduate medical education, a major concern is the proper balance between service and education. One of the guiding principles as stated in the "Essentials of an Approved Internship," is that a program's "educational function is of primary and paramount importance and its service function is secondary and incidental."
Yet it has long been apparent that the proper conduct of internship-residency programs entails the delivery of true medical services. While these services may relate most directly to patient care, it has been accepted by the AMA House of Delegates that the benefits of house officer services are shared by the community, the hospital, and the hospital attending physicians, as well as by the patients.
In 1962, columns in the Directory of Approved Internships and Residencies listing remuneration of interns and residents replaced the traditional heading "stipends" with a new heading "salaries." This change reflected the
SERVICE, EDUCATION, AND SALARIES. JAMA. 1968;206(9):2110-2111. doi:10.1001/jama.1968.03150090186030