Selective patient enrollment: a tool for improved residency training.

Providing a full range of problems to be managed in a model family practice unit is the goal of selective enrollment of patients at the Medical University of South Carolina. A computerized problem-oriented medical record is used to help distribute families with selected chronic diseases equitably to residents. Attention to the demographics of each resident's practice panel can help influence the distribution of health problems which a resident may experience at the model unit. Knowledge of the demographics of families at the model unit can help determine how representative they are of the surrounding community. Reallocation of families to new resident physicians when their old resident physicians complete training is logically planned. Work loads of resident physicians are monitored to adjust family assignments in their practice panels. The patient enrollment process is responsive to resident and faculty input regarding deficiencies in the health care experiences of the resident.