ABSTRACT
BACKGROUND: Clinical prevention is a critical component of primary care residency training. How well residents do preventive services is one measure of the adequacy of their training. METHODS: To assess the level of preventive health care in a university internal medicine residency clinic, we conducted a randomized retrospective review of 225 patient records. RESULTS: We documented preventive services in only 39% of potentially appropriate instances. Cholesterol screening occurred in 53% of eligible cases, breast examination in 41%, mammogram in 69%, Papanicolaou's smear in 53%, estrogen replacement therapy (ERT) in 41%, fecal occult blood testing in 30%, flexible sigmoidoscopy in 18%, influenza vaccination in 65%, pneumococcal vaccination in 44%, and tetanus immunization in only 9%. Male residents were significantly less likely than females to order mammograms or offer ERT. CONCLUSIONS: Compared to earlier studies of similar design, we found that the level of preventive health care has improved during residency training, but remains unacceptably low.
