Ambulatory care training during core internal medicine residency training: the Canadian experience.
OBJECTIVE
To determine the status of ambulatory care training of core internal medicine residents in Canada.


METHODS
Mail survey.


METHODS
All 16 program directors of internal medicine residency training programs in Canada.


METHODS
The nature and amount of ambulatory care training experienced by residents, information about the faculty tutors, and the sources and types of patients seen by the residents. As well, the program directors were asked for their opinions on the ideal ambulatory care program and the kinds of teaching skills required of tutors.


RESULTS
All of the directors responded. Fifteen stated that the ambulatory care program is mandatory, and the other stated that it is an elective. Block rotations are more common than continuity-of-care assignments. In 12 of the programs 10% or less of the overall training time is spent in ambulatory care. In 11 the faculty tutors comprise a mixture of generalists and subspecialists. The tutors simultaneously care for patients and teach residents in the ambulatory care setting in 14 of the schools. Most are paid through fee-for-service billing. The respondents felt that the ideal program should contain a mix of general and subspecialty ambulatory care training. There was no consensus on whether it should be a block or continuity-of-care experience, but the directors felt that consultation and communication skills should be emphasized regardless of which type of experience prevails.


CONCLUSIONS
Although there is a widespread commitment to provide core internal medicine residents with experience in ambulatory care, there is little uniformity in how this is achieved in Canadian training programs.
McLeod
P J
PJ
Department of Medicine, Montreal General Hospital, Que.
Meagher
T W
TW
D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002170:Canada; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000379:methods / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires