Jm. Colwill et al., MODIFYING THE CULTURE OF MEDICAL-EDUCATION - THE FIRST 3 YEARS OF THERWJ GENERALIST PHYSICIAN INITIATIVE, Academic medicine, 72(9), 1997, pp. 745-753
Citations number
34
Categorie Soggetti
Medicine, General & Internal","Education, Scientific Disciplines","Medical Informatics
The Generalist Physician Initiative (GPI) was created by The Robert Wo
od Johnson Foundation to help medical schools increase the number of p
redoctoral and residency graduates entering generalist careers. The un
derlying assumption of the GPI is that more medical graduates will bec
ome generalists if schools select candidates whose personal characteri
stics are compatible with generalist careers and if schools provide fo
r them an educational environment that values generalist careers in th
e same manner it has valued specialist careers. In essence, the GPI is
helping schools modify the culture in which medical education occurs
so that they may increase their production of generalists. Fourteen gr
ants for six years of support were made to 16 U.S. medical schools in
1994. These schools are developing institution-wide efforts that span
the continuum from the recruitment and selection of students through t
heir medical school and residency education to their entry into practi
ce, and include support of the practice. Most schools have developed e
xternal partners (e.g., state legislatures, managed care organizations
, area health education centers) to assist in achieving their goals. T
he project is now (1997) at its halfway mark. This article describes t
he conceptual bases for the program (e.g., changes in admission criter
ia to favor applicants oriented to generalism), identifies common appr
oaches to intervention chosen by the participating schools (e.g., esta
blishing longitudinal, generalist-oriented clinical experiences throug
hout the four years of medical school), and explores issues being face
d by the schools as they implement change (e.g., difficulties in decen
tralizing clinical education to include community physicians as teache
rs and role models).