Preparedness for clinical practice: reports of graduating residents at academic health centers

Abstract

Context: Medical educators are seeking improved measures to assess the clinical competency of residents as they complete their graduate medical education.

Objective: To assess residents' perceptions of their preparedness to provide common clinical services during their last year of graduate medical education.

Design, setting, and participants: A 1998 national survey of residents completing their training in 8 specialties (internal medicine, pediatrics, family practice, obstetrics/gynecology, general surgery, orthopedic surgery, psychiatry, and anesthesiology) at academic health centers in the United States. A total of 2626 residents responded (response rate, 65%).

Main outcome measures: Residents' reports of their preparedness to perform clinical and nonclinical tasks relevant to their specialties.

Results: Residents in all specialties rated themselves as prepared to manage most of the common conditions they would encounter in their clinical career. However, more than 10% of residents in each specialty reported that they felt unprepared to undertake 1 or more tasks relevant to their disciplines, such as caring for patients with human immunodeficiency virus/acquired immunodeficiency syndrome or substance abuse (family practice) or nursing home patients (internal medicine); performance of spinal surgery (orthopedic surgery) or abdominal aortic aneurysm repair (general surgery); and management of chronic pain (anesthesiology).

Conclusions: Overall, residents in their last year of training at academic health centers rate their clinical preparedness as high. However, opportunities for improvement exist in preparing residents for clinical practice.