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To the Editor:—
In the recent paper by Stapleton and Zwerneman on the influence of a resident staff on the quality of patient care (194:877, 1965), I believe the authors failed to consider one conclusion. There were differences between the teaching and nonteaching services, but they were relatively minor and the quality of care on both was obviously good. I do not think this justifies the conclusion in the accompanying editorial that "the studies referred to above seem to indicate clearly that improvement in the quality of care is not dependent upon the presence of an approved program in graduate medical education." Quite the contrary! If the educational program is as successful as Dr. Stapleton's, the effect would be manifested through the work of the staff even when no interns or residents were present. If the stimulus of graduate students failed to carry beyond their physical presence, the quality
Freymann JG. The Resident Staff and Patient Care. JAMA. 1966;195(13):1157. doi:10.1001/jama.1966.03100130131045