The interface between undergraduate and graduate medical education

The principal current problem related to the interface between undergraduate and graduate medical education is the lack of preparation of graduating medical students to assume many of the patient-care responsibilities required in certain graduate programs. There are two sides to the interface, and both require attention if the problem is to be resolved. The educational quality of the generally permissive fourth year of medical school should be examined in terms of the need for medical schools to prepare students for graduate educational programs. An effective broad first year of graduate medical education requires the development of institutional policy by all clinical departmental directors jointly and the delegation of operational responsibility to a small group of professionals.