To the Editor.
—Dr Schatz1 levies a strong argument for the institution of a block ambulatory care rotation in internal medicine training programs. The Department of Medicine at Oregon Health Sciences University, Portland, has had experience in both block and longitudinal clinic rotations for the last seven years. We would argue for a compromise from Dr Schatz' position.We concur with Dr Schatz that a block rotation allows the resident to direct attention to his office practice without the competition from the inpatient service, offers the opportunity for the introduction of valuable ambulatory care curricula, and can be a rewarding and informative experience.However, to argue that a block rotation of two to four months obviates the need for a longitudinal clinic experience is naive. Disease states evolve over time, often months to years, during which the physician is introduced to critical events in his patients' lives. In addition,
Girard DE, Elliot DL, Linz DH, Cooney TG. The Need for Longitudinal Ambulatory Care Training. Arch Intern Med. 1986;146(1):208. doi:10.1001/archinte.1986.00360130250049