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Does curriculum make a difference? A comparison of family physicians with and without rheumatology training during
G Schwartz1, J H Merenstein, F D'Amico
1Saint 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.