The role of office-based procedures in family practice residency training.

BACKGROUND: Fifteen years ago, the American Board of Family Practice determined the need for a procedural "core" list requirement for residency training. Program directors at that time could not reach a consensus about a specific list of procedures. This study examined the current attitudes of residency directors about a core list of office-based procedures required for residency training. METHODS: A questionnaire was designed to elicit general information about attitudes toward establishing a core requirement of office-based procedures. The program directors were asked to select from a list of 35 office-based procedures those they felt should be required. The questionnaire was mailed to all 421 US family practice residency directors. RESULTS: The response rate was 78%. Of responding directors, 68% favored a core list requirement. Eleven out of 35 procedures received at least 80% consensus by those directors favoring a core list requirement. Programs situated in rural areas were more likely to oppose the core list requirement. Geographic region of the residency program impacted on the number of core procedures respondents felt residents should master in their training. CONCLUSIONS: The majority of residency directors who responded believe that the potential advantages of a core list requirement outweigh the potential disadvantages. The directors approximated consensus (80% agreement) on seven procedures across all geographic regions. With this evidence in mind, it would seem appropriate for the governing bodies of family practice to reexamine the core procedure issue.

Assessing child development.

The family practitioner has an important role in the detection of infants and young children with developmental delays. The physician may be the first or only professional in regular contact with infants and young children. Interpretation of a child's developmental status is best done with a clear understanding of the child's family and social environment, and the family practitioner is in a unique position to possess this knowledge by virtue of his or her established relationship with the family.