CATEGORICAL MEDICINE RESIDENTS EXPERIENTIAL CURRICULUM

PURPOSE: TO assess the case mix or experiential curriculum of a univer sity-based categorical medicine residency program and compare the resi dents' continuity clinic case mix with the outpatients seen by practic ing internists. PATIENTS AND METHODS: Descriptive study during the 199 1-1992 academic year of 24,218 inpatients and outpatients from the Uni versity of California, San Francisco, Department of Medicine's three c ore hospitals: the University of California, San Francisco Hospital; t he Department of Veterans Affairs Medical Center; and the San Francisc o General Hospital. The diagnoses and ages of patients who made office visits to practicing internists from the National Ambulatory Medical Care Survey (NAMCS) were compared with corresponding data from the cat egorical medicine residents' continuity clinic patients. RESULTS: Seve nty percent of the general medicine inpatients at the three core hospi tals had one of the 25 most common principal diagnoses for inpatients. Eighty-seven percent of the patients seen by the residents in their c ontinuity clinic had one of the 20 most common diagnoses seen by pract icing internists in the NAMCS. The age distribution was similar in bot h groups. CONCLUSIONS: A systematic assessment of clinical training at one university-based hospital program shows that common internal medi cine problems represent the case mix of the great majority of patients , both inpatients and outpatients, seen by categorical medicine reside nts. Residents' continuity clinic patients are similar to patients see n by practicing internists. The program's challenge is to ensure that residents have adequate time with general medicine; experiences, both in the inpatient setting and in the ambulatory and longitudinal care s ettings, while balancing and integrating these activities.