Obstetrician-gynecologists are primary physicians to women

Our studies of the practice patterns of Michigan obstetrician-gynecologists indicate that they serve in a dual capacity: that of primary physicians to women and that of specialist obstetrician-gynecologists. They provide a considerable amount of general medical care for their own patients in the former role, and traditional specialist services for their own patients and for those referred by other physicians in the latter. The objectives and educational content of most house officer training programs do not reflect these changes. Training is directed almost exclusively toward preparing residents for specialty practice and often does not offer them basic experience and permit them to develop basic skills in other disciplines, notably internal medicine and psychiatry, which they will need to practice as primary physicians to women. An educational program designed to prepare residents more broadly for what they will actually be doing in practice without compromising their training as specialists is described.