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Several physician attitudes regarding telephone medicine can be measured reliably. Our findings suggest that improving systems for managing patient calls and improving telephone training for physicians will improve physician satisfaction and confidence with the practice of telephone medicine.

The results suggest that the proportion of IMGs in a residency program is a significant factor in program selection and is as important as previously established factors such as program reputation. Students, however, do not acknowledge the importance of this factor. Program directors and governing bodies may want to consider these findings when evaluating the impact and distribution of IMGs in U.S. training programs.

Background: Telephone medicine is an important but seldom-taught part of generalist physician's practices. Surveyed residents have expressed discomfort with this aspect of ambulatory care. Description: To determine if a telephone-medicine curriculum improves telephone-medicine skills of internal-medicine residents. Evaluation: Residents at West Virginia University (WVU) and the Moses Cone Memorial Hospital (N = 29) tested a telephone-medicine curriculum. They completed pre-and postcurriculum objective structured clinical examinations (OSCEs). Half of the WVU residents underwent the post-OSCE immediately and half after 6 months. All residents completed daily evaluations of the curriculum. Conclusions: The post-OSCE scores improved significantly( ps for each group < .01). Means of daily evaluationswere 4.2± 4.7 (on 1± 5 scales) for curricularcontent and delivery. The residents felt significantlybetter able to manage patients' calls after 2 sessions (p < .01). Improvement was seen in the telephone OSCE and was maintained 6 months later. This curriculum is well received and an effective method for teaching telephone-medicine skills.

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