A survey of residency management training: general preventive medicine graduates.

General preventive medicine residents at the University of Arizona are introduced to management skills and issues during graduate medical training to prepare them for future administrative positions. Our objectives were to learn whether administration training was effective and if acquired skills are useful in present job duties of graduates. We mailed a questionnaire to former general preventive medicine residents who had graduated between 1983 and 1992. Twenty-one (81.8%) of the 26 graduates returned a completed questionnaire rating the extent to which certain training activities improved administration skills and assessing the extent to which residency training overall prepare them for administrative work. Ratings reflected adequate preparation and usefulness of skills on the job. The survey indicates that administrative training should begin during residency years and that a variety of short-term and long-term activities, organized throughout both academic and practicum years can produce reasonable success in graduates. Medical Subject Headings (MeSH): preventive medicine, training.

Training the clinician-manager. Assessing the reality.

Occupational medicine residents at the University of Arizona have been introduced to administrative skills and issues as part of residency training since 1983. A questionnaire survey of 17 program graduates was conducted to assess effectiveness of training and applicability of skills to present job position. Seventeen of the graduates surveyed (100%) returned a completed questionnaire. Graduates rated the extent to which certain training activities improved administrative skills, such as community-based rotations, a 1-month administration rotation, chief resident responsibilities, committee work, program or clinic administration, and residency training overall. Although ratings overall were low, we believe this stems from the need for training that residents discover on the job. The survey emphasized the importance of administrative training during the residency years and underscored the need for renewed training efforts on our part.

Introducing management skills and issues in preventive medicine residency programs: a survey.

A questionnaire survey of 60 accredited preventive medicine residency programs was conducted to determine the percentage of programs in which management training is undertaken and to identify the nature of such training. Forty eight of the 60 programs (80%) returned a completed questionnaire. Forty three of the 48 programs responding (90%) state that the teaching of management skills is a defined goal of their program. Ninety percent introduce management skills in the practicum year in an administration rotation or by providing opportunities to practice management skills in other rotations. Thirty five (73%) of responding programs present didactic sessions containing a focus on management issues, and academic year courses contain a focus on management skills or issues in 46 (96%). Considering the need for management training in preventive medicine careers, we are encouraged by these figures. However, although this survey determined the extent to which management training is undertaken and the reported content thereof, it did not attempt to evaluate the depth or effectiveness of this training. Therefore, we must continue to emphasize a longitudinal and multidimensional approach to management training during the residency years.

A program of management training for residents.

To help prepare residents in preventive medicine and occupational medicine for their future management roles, the University of Arizona College of Medicine incorporated administrative training into many aspects of its residency programs, beginning in 1983. Training focuses on seven skill areas seen as needed to meet the management demands of the physicians' future specialties. The authors discuss the career choices of University of Arizona graduates and advocate long-term administrative training for all specialties.

Management roles for physicians: training residents for the reality.

The University of Arizona has incorporated administrative training into general preventive medicine residency and occupational medicine residency training programs to provide preparation at the most appropriate time for future management roles for physicians. Training parallels future specialty choices and focuses on computer skills, fiscal control, budgeting, personnel management, political or regulatory process, program development, and planning and organization. Throughout the 2-year training period, residents are in a position to acquire management skills through course work, selected rotations, special projects, and a concentrated 1-month rotation in administration. Practical application is exercised in management settings within the department and in the community. A longitudinal training approach is advocated for similar programs and for other specialties to ensure successful management of health care with physicians as an integral component.

An unsuccessful experience with computerized medical records in an academic medical center.

Computerized medical records systems are used in only a small percentage of U.S. health care facilities, despite predictions that they would be widely used. The authors here report on their experience with the Computer Stored Ambulatory Record (COSTAR), a computerized medical records system, installed at a large primary care clinic at a university medical center. Although some equipment and computer resources were provided by the medical center, ongoing operations were financed by clinic revenues. After four months, use of the system was terminated because clinic revenues could not cover operating costs. The operating costs accounted for 17 percent of the average charge for an office visit. The major component of the operating costs was personnel expenses for data entry.