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July 14, 1978

The Academic Viability of Family Medicine: A Triad of Challenges

Author Affiliations

From the Yale-New Haven Medical Center, and Yale University School of Medicine, New Haven, Conn.

JAMA. 1978;240(2):132-135. doi:10.1001/jama.1978.03290020054023

EVERY innovation in medical education must ultimately prove itself academically; that is, it must define and demonstrate clearly what it can contribute uniquely to teaching, the care of patients, and the work of colleagues. Family medicine, which has been established largely through forces external to academia, has yet to meet these sterner tests of longterm survival. The question for the decade immediately ahead is whether it can sustain its claim as an integral element in medical education.

The record of innovations engrafted on the body of medical education is not encouraging. Rehabilitative medicine, community medicine, behavioral sciences, interdisciplinary teaching, three-year curricula—all enjoyed an initial vogue. After begrudging acceptance, they have, to various degrees, gradually been buffered, absorbed, curtailed, or rejected. All face a dubious future in the current conservative climate of medical schools.

Like other innovations, academic family medicine arises from a perceived social need. But it cannot meet that