Family Practice Graduate IBAB

Comments on the Internet Based Annotated Bibliography
on Outcomes Studies of Family Practice Residency Graduates

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In 1989, I was asked to write a preface to Tom Browns review of 20 years of literature on the outcomes of family practice training. I am pleased that this work, which has been out of print for over a decade, has been selected to become a core contribution to the first of the several planned Internet Based Annotated Bibliographies. It is envisioned that the wider community of scholars interested in the outcomes of family physician education will work with the curators of this project to update and amplify Toms valuable compilation of information on the first two decades of the family medicine specialty in the United States.

William H. Burnett
Conference Program Coordinator
The National Conference on Primary Health Care Access

TWENTY YEARS OF FAMILY PRACTICE
GRADUATE FOLLOW-UP STUDIES

By Thomas C. Brown, Ph.D.
with preface by William H. Burnett

PREFACE

This publication represents an attempt to organize in some meaningful way published studies about the characteristics of graduates of family practice training programs. Such outcome studies and others to be published in the future chronicle one of the most interesting developments in postgraduate training in recent years -- the invention of a medical specialty which draws on a normative vision of primary health care delivery. The major contours of family practice residency training -- the composition of its curriculum, the institutionalization of continuous, comprehensive care to families through the family health centers, and the incorporation of behavioral sciences and community medicine -- were all proposed and promoted by blue ribbon panels representing society as a whole. No other medical specialty evolved this way.

It is my hope that this publication will be of immediate use to those who ponder whither goes this specialty; and will be updated from time to time to incorporate the comprehensive studies of the discipline that are now in planning and those that are yet to be conceived.

William H. Burnett
Sacramento, California

INTRODUCTION

The societal forces that brought about the reformation of the medical field to include primary care as a unifying principle became institutionalized in the identification and development of the discipline of family practice. However, no group can claim professional standing without explicit statements about what constitutes training in that field and the means by which such training can be assessed. This collection of abstracted studies is an attempt to focus attention on the results of educational efforts to meet primary care needs of the nation. The attention given to program outputs by the family practice field, when compared to other fields, is evidence that the practitioners of family practice medical education are being responsive to the charge given to the field by society. The tracking of graduates into practice, with analyses of their activities, perceptions of their training strengths and weaknesses, and their distributions, provides solid evidence for current and future policy-makers.

Not all of the studies about graduates of family practice appear in the Medicus Index and not all are titled in such a manner that the article content is revealed. However, an attempt was made to find at least the obvious articles written in the medical literature about graduates of family practice residency programs since the inception of the specialty.

Articles on the subject were zeroxed and ordered by date. That is the order of this work. The abstracting system used was patterned after Ross R. Black's excellent work with AAFP in describing residency programs. Mis-reporting of facts or errors of interpretations are mine alone.

I want to thank John P. Geyman, M.D., for being my early mentor and for his outstanding contributions to this area, Norman T. Woolf, M.D., former Program Director in Redding, California, for always wanting more specific information on his graduates so he could evaluate "how he was doing," and Bruce S. Nickols, M.D., Program Director in Stockton, California, who allowed me the time and showed extra-ordinary patience as this work was executed. Let us hope we are training family physicians who can wear the shoes of these pioneer "people" docs.

Roberto Urzua, the librarian at San Joaquin General Hospital, provided invaluable help in the search for articles, much beyond anything one could ask. Finally, I want to thank my wife, Nancy, and our four grown kids and four gr andkids and their mothers, for being the kind of family that has always given support to me, where ever the path led.

Thomas C. Brown, Ph.D.
Stockton, California
April, 1989