July 1990

A New Golden Standard for Residency Training

Author Affiliations

Johnson City, Tenn

Arch Intern Med. 1990;150(7):1548-1550. doi:10.1001/archinte.1990.00390190178037

To the Editor.—I would like to applaud Dr Joseph Flaherty's1 observations on the evolution of graduate medical education over the past 75 years, and his recommendations for change. The design and implementation of such changes might result in requirements for residency training such as: Experience in continuity of care (in an (Continued on p 1550.) (Continued from p 1548.) ambulatory setting) is essential... emphasis on the importance of comprehensive patient care... assuming responsibility for the total health care of the individual... taking into account the social, physiological, economic, cultural, and biologic dimensions... the primary setting for training should be ambulatory....

The curriculum should include "certain elements... of special importance"—health assessment and maintenance, prevention, human behavior (the doctor-patient relationship, patient counseling, patient education), community medicine (occupational medicine, epidemiology, community health education), practice management, the art of consultation and referral... only to reiterate a few of the important areas.

For a

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