The future of procedural training in family practice residency programs: look before you LEEP

Procedural training is a tremendously important issue and has implications for what and how we teach family physicians. Should we continue with an increasingly densely packed longitudinal model of training, or do we move to a more explicitly structured block design? Should our decisions be guided by community needs, marketplace demands, or available technology? Finally, and most importantly, how can we determine the performance quality of the procedures we choose to perform and teach? Each of these questions calls for an extended dialogue among practicing family physicians, family physician educators, and those who participate in--and pay for--primary health care. It is clearly time for this dialogue to begin in earnest.