[Has the time come to transfer residency training from hospitals to the community? Lessons from other countries and implications for Israel].
Most medical practice has moved from the hospital to the community. Nevertheless, in the western world, including Israel, residency training in various specialties has remained mostly in the hospital. Residents have no opportunity to encounter the morbidity and the patient mix that they are likely to encounter in their future work life in the community, after their residency. Neither do they have any opportunity for practical training in medical procedures that are now practiced mainly in the ambulatory setting. Therefore, efforts are being made to promote community work in residency training in order to adapt it to medicine of the future. In this literature review the authors summarized the accumulated experience of transferring residency to ambulatory settings in other countries. The literature review deals with the organizational aspects of accreditation of residency training and with ways of coping with budgetary difficulties as well as infrastructure and faculty recruitment issues. It also reviews the accumulated experience with the content of community residency: the acquisition of knowledge and medical skills, and the maintenance of academic standards. This was done in order to benefit from the lessons learned from others' experience and to raise public discussion issues related to the implementation of this process in Israel.
Nirel
Nurit
N
Myers-JDC-Brookdale Institute, Israel. nuritn@jdc.org.il
Birkenfeld
Shlomo
S
Israeli
Avi
A
D003151:Community Health Centers; D004502:Education, Medical, Continuing; D005551:Foreign Professional Personnel; D006801:Humans; D007396:Internship and Residency; D007557:Israel; D008505:Medical Staff, Hospital