Surgery is the first of the branches of medicine to be severely hampered in its graduate teaching by the changing economic status of patients. Halsted introduced to the United States the present type of residency training, which is modified from the German system. This type of training, now adopted by most other branches of medicine, provides gradually increasing experience and responsibility until the final year, when complete or nearly complete responsibility is given to the resident. Surgery is the first specialty to be seriously affected, because voluntary surgical fee insurance is the most popular type of medical fee insurance today. Thus, surgery, the most popular type of graduate medical training, is the first specialty to have its graduate medical training affected by the changing economic status of patients. It is also obvious that, when in the future there is complete or nearly complete coverage of all individuals by professional fee
Zintel HA. POSTGRADUATE SURGICAL TRAINING AND THE CHANGING ECONOMIC STATUS OF PATIENTS. JAMA. 1958;167(2):211–214. doi:10.1001/jama.1958.02990190065014
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