Training internists: insights from private practice.

University internal medicine training programs concentrate on the traditional curriculum designed to produce well-trained academicians and researchers. Increasingly internists are involved in primary patient care with over two-thirds being office based practitioners. Residency training at these institutions must make available to all residents the opportunity to learn the skills taught by primary care programs. Clinical problem solving, skills in patient-physician negotiations and patient comfort, psychiatric techniques, medical ethics, cost effectiveness analysis, and practice management are areas in which the private practitioner frequently needs help. Feedback from training program graduates in private practice could help identify such deficiencies which could be incorporated into the teaching responsibility of a division of general internal medicine.