Preparedness for clinical practice - Reports of graduating residents at academic health centers

Context Medical educators are seeking improved measures to assess the clini cal competency of residents as they complete their graduate medical educati on. Objective To assess residents' perceptions of their preparedness to provide common clinical services during their last year of graduate medical educat ion. Design, Setting, and Participants A 1998 national survey of residents compl eting their training in 8 specialties (internal medicine, pediatrics, famil y practice, obstetrics/gynecology, general surgery, orthopedic surgery, psy chiatry, and anesthesiology) at academic health centers in the United State s. A total of 2626 residents responded (response rate, 65%). Main Outcome Measures Residents' reports of their preparedness to perform c linical and nonclinical tasks relevant to their specialties. Results Residents in all specialties rated themselves as prepared to manage most of the common conditions they would encounter in their clinical caree r. However, more than 10% of residents in each specialty reported that they felt unprepared to undertake 1 or more tasks relevant to their disciplines , such as caring for patients with human immunodeficiency virus/acquired im munodeficiency syndrome or substance abuse (family practice) or nursing hom e patients (internal medicine); performance of spinal surgery (orthopedic s urgery) or abdominal aortic aneurysm repair (general surgery); and manageme nt of chronic pain (anesthesiology). Conclusions Overall, residents in their last year of training at academic h ealth centers rate their clinical preparedness as high. However, opportunit ies for improvement exist in preparing residents for clinical practice.