Criteria for including study of specific conditions during clerkship training in internal medicine

A survey was conducted of physicians in practice, to determine the criteria that would lead the study of a particular condition to be an important component of clerkship training in internal medicine. Four such criteria weresuggested: the prevalence of the condition in practice, the urgency with which it requires attention, the severity in terms of morbidity and mortality and the cost effectiveness of the intervention. The responses suggest that those inpractice see prevalence, urgency and severity as criteria of almost equal weight, but place cost-effectiveness on a much lower priority. Unexpectedly, those who have been in practice many years are more concerned about the role of the cost-effectiveness of the intervention than recent graduates. Also specialists see this as being a more importantcriterion that family practitioners. Those with a faculty position in academic medicine have views which are similar to those who do not. Thus, in attempting to design the ideal clerkship, there is a widespread view that the role of cost effectiveness in treatment should receive a lower priority in determining curriculum content than prevalence, urgencyor severity. On the basis of these data, the request that there be increased weight of cost-effectiveness in determining curriculum content, will not receive strong endorsement from those in practice.