This approach has the potential to not only help deconstruct the process of decision making regarding specialty choice but also uncover information about the best ways to help medical students learn to make wise decisions.

This study examined the effects of a small‐scale, very short‐term (8–10 h) service‐learning experience on college undergraduates. Repeated measures analysis of variance indicated that students participating in this experience reported maintenance of their sense of social responsibility, an increased sense of the meaningfulness of college, and an increased likelihood of choosing a service‐related occupation, when compared to non‐participating matched counterparts. These findings provide support for the notion that minimally resource‐intensive service‐learning programs can provide students with some of the benefits of service‐learning that have been identified in longer, more intensive experiences.

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Increasing attention has been focused on developing professionalism in medical school graduates. Unfortunately, the culture of academic medical centers and the behaviors that faculty model are often incongruent with our image of professionalism. The need for improved role modeling, better assessment of student behavior, and focused faculty development is reviewed. We propose that the incentive structure be adjusted to reward professional behavior in both students and faculty. The third-year medicine clerkship provides an ideal opportunity for clinician-educators to play a leading role in evaluating, rewarding, and ultimately fostering professionalism in medical school graduates.

I PUlpose:To assess knowledge and associated factors in palliative care. Methods: Self-administered survey of 88 internal medicine house officers in 1996. Results: Twenty-one interns and 36 residents completed the survey for a response rate of 65%. Most house officers reported 1-5 hours of prior formal training in palliative care, 1-5 hours in pain management, and 6-20 hours in ethics. The mean knowledge score Was 75% correct (SD=8); pain management scores were lowest (70%). Overall, interns had a significantly lower mean score than residents (70% vs. 77%; P=0.001). In multivariate analysis, only the year of residency was significantly associated with knowledge Score; prior formal training in palliative care, pain management, or ethics was not. One third of house officers rated themselves as "not at all" or "only slightly" at ease in caring for a dying patient. These self-ratings were not associated with prior training or knowledge, but were higher in residents compared to interns. Conclusions: Palliative care knowledge and ease with dying patients were higher in later years of residency but were not associated wnh prior fonnal palliative care training. These data highlight the continued need to evaluate and improve training in palliative care and pain management.