Performance on preventive cancer screening tests in the ambulatory setting by internal medicine resident physicians.
BACKGROUND
Limited information exists about the quality and determinants of ambulatory care by resident physicians.


METHODS
This study investigated whether year of training and primary care versus traditional categorical status for internal medicine residents influenced preventive cancer screening rates. Ambulatory patients cared for by 143 internal medicine residents in one program over a 1-year period were assessed. Patients eligible for breast, cervical, and colorectal cancer screening were identified and test completion status was assessed. Patients who had not yet completed screening and had a visit with the resident physician were prospectively followed for subsequent test completion. Cancer screening rates, overall and among those overdue, were compared controlling for baseline patient characteristics.


RESULTS
Among 3, 729 patients, overall test completion rates for breast (72%), cervical (75%), and colorectal cancer screening (56%) did not differ by year of training or type of training (primary care vs. categorical). Among patients overdue for a screening test, no association was found by resident year of training or primary care versus categorical status: 22% vs. 12% for colorectal (p = .08), 46% versus 28% for breast (p = .69), and 24% versus 19% for cervical cancer (p = .61), respectively.


CONCLUSIONS
Neither resident physician type of training nor year of training were found to be associated with cancer screening rates in the ambulatory setting. Future research should seek to identify physician factors and educational strategies to augment system-based efforts to improve the quality of outpatient care by resident physicians.
An
Perry G
PG
Medical Services, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Ashburner
Jeffrey M
JM
Fosburgh
Blair W
BW
Atlas
Steven J
SJ
D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data*; D008404:Massachusetts; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D011446:Prospective Studies