DEFINING A GENERALIST EDUCATION - AN IDEA WHOSE TIME IS STILL COMING

Generalist education is different from the traditional medical curricu lum as it has developed over the past 40 years. For example, in their training doctors must develop the appropriate skills, knowledge, and a ttitudes to understand patients' specific expectations, address wellne ss rather than illness only, be familiar with concepts of clinical epi demiology, concentrate on interpersonal communication, and strive to c ontrol costs. The University of Illinois College of Medicine at Rockfo rd was established to provide community-based medical education. Begin ning in their second year, all Rockford students have extensive clinic al training in one of three community health centers operated by the D epartment of Family and Community Medicine. Several kinds of evaluatio n have been conducted to assess the reaction to and impact of this cli nical training on the students and faculty, and follow-up studies have tracked, the students after graduation. The Rockford experience has s hown that the entire curriculum must give uncompromising support for g eneralist education, all primary care faculty must have a common knowl edge-base in the theory and practice of generalist medicine, and the s hift to generalist education will require shifts in attitude and behav ior throughout the academic medicine community at the institution.