THE TITLE of this discourse struck me as somewhat unusual when it was assigned to me. I am not accustomed to thinking of ground rules in connection with specialization or education. The title was not changed, in spite of an invitation to do so, for, on second thought, the phrase "ground rules" seemed a fortunate one. When one thinks of ground rules in connection with a sport, the implication is that they are local ground rules and may vary from place to place, depending on local conditions.
Medical specialties and specialist training is becoming increasingly formalized, and standards are being raised. However, the problems of the different specialties are different, and each one requires different standards. Ground rules therefore seems a good term to describe these diverse standards generally. Further, the facilities and capabilities of different advanced educational centers vary, and it is important that we do not force different
Adams W. Ground Rules of Specialization and Advanced Education in Medicine. JAMA. 1963;185(6):445–447. doi:10.1001/jama.1963.03060060043016