Does curriculum make a difference? A comparison of family physicians with and without rheumatology training during residency
G. Schwartz, J. H. Merenstein, F. D'Amico and A. Agarwal
Saint Margaret Memorial Hospital, Pittsburgh, Pa.
OBJECTIVE: To assess the long-term effect of an extensive rheumatology
curriculum on graduates of family practice residencies. DESIGN: Cohort
analytic study using a mailed survey and a multiple-choice test based on
clinical vignettes that were administered 3 to 7 years after graduation
from residency training. PARTICIPANTS: Practicing family physicians who had
graduated from a community hospital family practice residency with an
extensive rheumatology curriculum (trained) were compared with graduates
from a similar program without specific rheumatology training (untrained).
MAIN OUTCOME MEASURES: Total test scores, results of individual test
questions, practice style, and attitudes toward rheumatology training and
practice. RESULTS: We received 39 (85%) responses from 46 potential
respondents in the trained group and 25 (89%) responses from 28 potential
respondents in the untrained group. Physicians in the two groups had
similar backgrounds and practice styles. The trained physicians scored
higher on the multiple-choice test (mean +/- SD, 25 +/- 5 vs 22 +/- 6; P
< .03). The clinical significance of these differences is a matter of
individual interpretation. One hundred percent of the trained physicians
believed that the quality of their rheumatology training was good to
excellent compared with 25% of the untrained physicians. Seventy-six
percent of the untrained physicians wished that they knew more about
rheumatology. No variables other than rheumatology training accounted for
the differences between the two groups. CONCLUSIONS: The difference in
rheumatology knowledge, evident during and soon after residency between
trained and untrained physicians, persists for 3 to 7 years.
