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IT SEEMS evident that changes in medical economics have made the use of private patients mandatory for graduate medical education in both university and nonuniversity hospitals. The matter here discussed is the quality of education so derived. Can it be good?
The development and organization of such programs is an exceedingly heavy responsibility, for at stake are not only the careers of the young doctors participating in them, but the general quality of medical care in the community as well. Those in charge must be keenly sensitive to this responsibility, and to the important implications of what they are doing.
Lamentably, in some hospitals this responsibility is not always met, or even appreciated, and the emphasis is placed not on the quality of the educational experiences afforded, but rather on the urge to meet the practical needs of the attending staff or the hospital administration. Education becomes a garment to cover a series of practical needs which actually dominate the program, and eventually destroy it.
Philip A. Tumulty. House Staff Education on a Private Medical Service. JAMA. 1963;185(12):943–948. doi:10.1001/jama.1963.03060120053021