Megatrends in pathology practice: implications for residency training. Ninth Conference for pathology residency program directors--a summary.

The participants at the Ninth Conference for Pathology Residency Program Directors clearly identified the important trends, the problems, and the opportunities now confronted by the specialty of pathology. Equally important, the speakers identified changes that should be incorporated into residency programs if we are to provide the training and education for practice in a changing medical environment. Evaluations of the program by the participants indicated it had been a valuable conference and it should be maintained as a part of each annual American Society of Clinical Pathologists/College of American Pathologists Fall Meeting.

Senior House Officer training in geriatric medicine.

The training of the 72 Senior House Officers working in geriatric medicine in the Yorkshire Region was assessed by questionnaire. Most of the 67 respondents considered their training requirements in geriatric medicine had been fulfilled and experience had been gained in acutely-ill and long-stay elderly patients. However, there were deficiencies in the provision of topic teaching, case presentation meetings, rehabilitation instruction, and in experience of the day hospital and domiciliary assessment visits. Attention to the training requirements of the Senior House Officer grade could help to improve care of the elderly in both hospital and general practice.

Outpatient cataract surgery by ophthalmology residents in a county hospital.

As more people come to depend on public hospitals for health care, fewer inpatient beds are available for elective ocular surgery. At our county hospital, ophthalmology residents with faculty supervision have successfully performed cataract surgery on an outpatient basis. The postoperative outcomes of these outpatients are similar to those of a corresponding inpatient population. Outpatient cataract surgery can preserve the quality of patient care while providing potential advantages.

Projecting physician requirements for child health care-1990.

In 1976 the Secretary of the Department of Health, Education and Welfare appointed the Graduate Medical Education National Advisory Committee (GMENAC) with the charge to advise the Secretary on five national health planning objectives, including estimates of the numbers of physicians required to meet the health care needs of the nation, recommendations regarding the most appropriate specialty distribution of these physicians, and development of strategies to achieve the recommendations formulated by the committee. GMENAC evaluated projected supply and requirements for all major specialties, including child health care, for 1990, and recommended strategies to bring supply and requirement into reasonable balance. Despite the range of error of the methodology used, these data represent the most detailed scientific study to date on this subject. Pediatrics, the portion of child health care accruing to the pediatrician in 1990 was projected to be in "near balance" for supply/requirement ratio. Inasmuch as GMENAC recommended that larger surpluses be created deliberately in the three primary care fields, it is unlikely that the numbers of pediatric residency training programs will be decreased. As several hundred pediatric residency positions are unfilled each year, a concomitant decrease in residency offerings in oversupplied fields would be required to accomplish the recommended subspecialty distribution.

A comparison of primary care residents with conventional internal medicine and pediatric residents.

A study was done of 15 residency training programs in primary care (not family practice residencies) to determine how the residents compared with their counterparts in conventional programs. Primary care residents are equally or more clinically skilled and equally or better grounded in the science of medicine. Their clinical research is directed toward different issues, and they are decidedly more psychosocially oriented.