Strengthening academic generalist departments and divisions

Abstract

Academic departments of family medicine and divisions of general internal medicine and general pediatrics exist in the majority of medical schools in the United States and have important roles in generalist medical education. The major organizational issues facing these units concern institutional influence, faculty development, role in medical education, research productivity, financial stability, and clinical responsibilities. These issues must be understood in order for medical schools and teaching hospitals to achieve the societal goal of producing necessary generalist physicians.

Contributions of general internal medicine teaching units

“…6,7 It is a national survey with an acceptable response rate. It is also the first study of its kind to provide information important to understanding the resources being used for general medicine education.…”

“…Previous studies of general internal medicine divisions focused only on those in medical school or university medical centers, missing the educational contributions of internists who were working in community settings. 6,7 To identify and describe general internal medicine teaching units, we conducted a national survey of heads of such units, including those in both university and community settings. dency programs.…”

Guidelines for promotion of clinician-educators

“…12,16,22 The concepts of reappointment, promotion, scholarship, and expectations require further delineation. Reappointment is the regular recontracting (every 1 to 3 or more years) with an academic faculty member.…”

“…For example, most new faculty require 5 years to launch a successful academic career, even with reasonable provision for protected time and participation in fellowships or faculty-development programs. 22 New clinicianeducators may be delayed in establishing a patient base, and practices that include students may be less efficient than nonteaching practices. 23,24 This is a special concern for teaching in high-volume managed care settings.…”

“…Obstacles in performing research (e.g., focus, time) can be overcome, 27 but it is unreasonable to expect clinician-educators to devote equivalent amounts of time to research and continue to perform all activities equally well. 22 Many will serve as collaborators, rather than principal investigators, on extramurally funded projects. Clinician-educators should contribute to institutional review boards, to the setting of research priorities, and to the interpretation of data on collaborative research.…”