Graduate medical education and certification in physical medicine and rehabilitation

The American Board of Physical Medicine and Rehabilitation has certified 1608 physiatrists as diplomates, of whom 377 were certified in the years 1977 through 1979. For the 1979-1980 educational year, 516 of 608 residency positions were filled. Demographic analysis indicates 43% women and 52% foreign medical graduates (FMG) with an increasing female-to-male ratio and a decreasing ratio of FMGs to American medical graduates (AMGs). On the basis of proposed indices of productivity and quality and of results in the certifying procedures, the 62 currently accredited training programs show a wide distribution of effectiveness. A majority of programs are of good quality and are productive. A significant number apparently have problems that warrant critical self-analysis of all aspects of the educational endeavor. Increased productivity is needed in view of the shortage in the number of persons working in the specialty. Attention should center on recruitment and appointment of good residents, building of strong and effective faculties, and provision of stimulating, balanced educational experiences. Evaluation of competence is a dual function of the training programs and the specialty boards and is currently undergoing in-depth study under the sponsorship of the American Board of Medical Specialties (ABMS).