Physician office laboratory education and training in primary care residency programs
D. G. Ferris, H. J. Hamrick, P. G. Pollock, A. J. Stinson, J. Crenshaw, E. F. Wahl, A. S. Koenig, P. M. Fischer and J. S. Kroger
Department of Family Medicine, Medical College of Georgia, Augusta.
OBJECTIVE: To assess the status of office laboratory residency education
and training in family practice, internal medicine, obstetrics and
gynecology, and pediatric residency programs. DESIGN: A single mailed
survey to 1299 residency programs from December 1992 to February 1993.
PARTICIPANTS: Primary care residency directors from 507 (39%) of 1299
programs. INTERVENTIONS: A 27-item survey of residency-based office
laboratory practices, education, training, and resources. MAIN OUTCOME
MEASURES: Differences between specialties in provision and quantity of
office laboratory education and training, presence of a residency-based
office laboratory, laboratory classification under the Clinical Laboratory
Improvement Amendments, and available laboratory tests. RESULTS: Of those
responding, office laboratories were present in 89% of family practice, 19%
of internal medicine, 29% of obstetrics and gynecology, and 24% of
pediatrics residency programs. Laboratory training was available at 60% of
family practice, 16% of internal medicine, 15% of obstetrics and
gynecology, and 30% of pediatrics programs. The median number of hours of
formal skills training was 10 hours for family practice residency programs
but less than 2 hours for the other specialties. Only 25% of the programs
reported educational assistance from pathologists. Merely 4% of the
programs had postassessment examinations and 2% awarded certificates of
achievement. A majority of family practice programs performed waivered
tests and physician-performed microscopy tests, but moderately complex
tests were performed in less than 50% of family practice programs.
CONCLUSIONS: Family practice residency programs provide more office
laboratory training for residents than other specialties. There is a need
for improved residency training in the basics of office laboratory
practice.
