Medical school culture and generalist education: perceptions of a medical school faculty

As part of an initiative to promote the education of generalist physicians at the University of North Carolina, a series of meetings were held over a 12-month period between generalist senior faculty and faculty from a range of departments in the School of Medicine and other health professions schools. Through open discussion about generalist initiatives, we hoped to understand their issues, attitudes, and opinions regarding generalists and generalist education. The major themes arising from these dialogues were 1) uncertainty about the definition of the generalist physician, 2) beliefs about the poor clinical reputations of generalists, 3) lack of a scientific basis for generalist practice, and 4) beliefs that few new resources are needed to undertake and expand generalist education. We comment on the validity and possible reasons for these perceptions and suggest strategies that can enhance generalist culture in the medical school.