Nelson H D, Cooney T G, Kroenke K, Friedman R H
Departments of Medicine, Oregon Health Sciences University, Portland, Oregon 97201, USA.
J Gen Intern Med. 2000 May;15(5):277-83. doi: 10.1046/j.1525-1497.2000.03329.x.
To identify and describe general internal medicine teaching units and their educational activities.
A cross-sectional mailed survey of heads of general internal medicine teaching units affiliated with U.S. internal medicine training programs who responded between December 1996 and December 1997.
Responses were received from 249 (61%) of 409 eligible programs. Responding and nonresponding programs were similar in terms of university affiliation, geographic region, and size of residency program. Fifty percent of faculty received no funding from teaching units, 37% received full-time (50% or more time), and 13% received part-time (under 50% time) funding from units. Only 23% of faculty were primarily located at universities or medical schools. The majority of faculty were classified as clinicians (15% or less time spent in teaching) or clinician-educators (more than 15% time spent in teaching), and few were clinician-researchers (30% or more time spent in research). Thirty-six percent of faculty were internal medicine subspecialists. All units were involved in training internal medicine residents and medical students, and 21% trained fellows of various types. Half of the units had teaching clinics located in underserved areas, and one fourth had teaching clinics serving more than 50% managed care patients. Heads of teaching units reported that 54% of recent graduating residents chose careers in general internal medicine.
General internal medicine teaching units surveyed contributed substantial faculty effort, much of it unfunded and located off-campus, to training medical students, residents, and fellows. A majority of their graduating residents chose generalist careers.
识别并描述普通内科教学单位及其教育活动。
对1996年12月至1997年12月间回复的美国内科培训项目附属普通内科教学单位负责人进行横断面邮寄调查。
409个符合条件的项目中有249个（61%）回复。回复和未回复的项目在大学附属关系、地理区域和住院医师项目规模方面相似。50%的教员未从教学单位获得资金，37%获得全职（50%或更多时间）资金，13%获得兼职（少于50%时间）资金。只有23%的教员主要在大学或医学院工作。大多数教员被归类为临床医生（教学时间占15%或更少）或临床教育工作者（教学时间超过15%），很少是临床研究人员（研究时间占30%或更多）。36%的教员是内科亚专科医生。所有单位都参与培训内科住院医师和医学生，21%培训各类研究员。一半的单位在服务不足地区设有教学诊所，四分之一的单位有教学诊所为超过50%的管理式医疗患者提供服务。教学单位负责人报告说，最近毕业的住院医师中有54%选择从事普通内科职业。
接受调查的普通内科教学单位在培训医学生、住院医师和研究员方面投入了大量教员精力，其中很多没有资金支持且位于校外。他们的大多数毕业住院医师选择了通科职业。
