Does Curriculum Make a Difference?
A Comparison of Family Physicians With and Without Rheumatology Training During Residency
Gary Schwartz, MD;
Joel H. Merenstein, MD;
Frank D'Amico, PhD;
Amrit Agarwal, MD
Arch Fam Med. 1994;3(3):263-267.
To assess the long-term effect of an extensive rheumatology curriculum on graduates of family practice residencies.
Cohort analytic study using a mailed survey and a multiple-choice test based on clinical vignettes that were administered 3 to 7 years after graduation from residency training.
Practicing family physicians who had graduated from a community hospital family practice residency with an extensive rheumatology curriculum (trained) were compared with graduates from a similar program without specific rheumatology training (untrained).
Main Outcome Measures
Total test scores, results of individual test questions, practice style, and attitudes toward rheumatology training and practice.
We received 39 (85%) responses from 46 potential respondents in the trained group and 25 (89%) responses from 28 potential respondents in the untrained group. Physicians in the two groups had similar backgrounds and practice styles. The trained physicians scored higher on the multiple-choice test (mean±SD, 25±5 vs 22±6; P<.03). The clinical significance of these differences is a matter of individual interpretation. One hundred percent of the trained physicians believed that the quality of their rheumatology training was good to excellent compared with 25% of the untrained physicians. Seventy-six percent of the untrained physicians wished that they knew more about rheumatology. No variables other than rheumatology training accounted for the differences between the two groups.
The difference in rheumatology knowledge, evident during and soon after residency between trained and untrained physicians, persists for 3 to 7 years.
From the Family Practice Residency and Fellowship Program, Saint Margaret Memorial Hospital, Pittsburgh, Pa. Dr Schwartz is now with the Shepardstown Family Practice, Mechanicsburg, Pa.
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