The core content of a generalist curriculum for general internal medicine, family practice, and pediatrics

Abstract

The authors analyzed the educational content of the curricula developed for teaching in the generalist disciplines of pediatrics, family medicine, and general internal medicine. Fifteen educational components that constitute the core content shared by the three generalist disciplines are identified, described, and referenced. Tailoring the generalist curriculum for students and residents at the different stages of learning is reviewed, along with the refinement of the curriculum to meet the special needs of each generalist discipline. The success of a generalist curriculum will ultimately be measured by generalist career choices, quality of care, and both patient and professional satisfaction. The curricular determinants of success require institutional commitment to an educational philosophy that embraces the generalist disciplines, a core curriculum that provides education and training that are correlated with the demands of clinical practice, and generalist faculty who serve as role models, mentors, and teachers.

Two Tiers of Physicians in France

“…For example, in the United States, as subspecialists and hospitalists take over hospital care, 30 family practitioners, general internists, general pediatricians, and medicine-pediatrics physicians are increasingly seen by insurers, policymakers, and educators as different varieties of office-based primary care physicians. [31][32][33] The pluralism and specialist training of these primary carephysiciansare,incomparisontoFrance,astrengthoftheUS health care system, but unlike in France, such pluralism has opened the way for the creation of a new tier of primary health care practicioners: nurse practitioners and physician assistants.…”

Differences in residents’ self-reported confidence and case experience between two post-graduate rotation curricula: results of a nationwide survey in Japan

“…While the dichotomy between general and specialty medicine exists in health systems outside of Japan, as evidenced by increasing resident shifts from generalist to specialist post-graduate training programs in the United States, the benefits of specialists receiving initial training in an accredited general curriculum has been a well-established educational paradigm in both the US and UK, as well as numerous other countries [14-16]. In addition, health systems built around the central pillar of primary care gatekeeping may provide a buffer which allows both specialists and generalists to practice safely within their field of training.…”

What the Surgeon of Tomorrow Needs to Know About Evidence-Based Surgery

“…Improved education in searching for EBM during medical school and residency training and full access to information to assess and use evidence-based patient care are lacking for all physicians, and surgical specialists in particular. 43 Necessary skills include defining the patient problem exactly, effectively searching and critically assessing current information, and appropriately applying the knowledge to care for an individual patient. 44,45 A lack of implementation of evidence-based care involves both commission and omission at the level of the physician and institution.…”