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For the second year, the Department of Data Systems in the Medical Education Group of the American Medical Association gathered information on graduate medical education primarily by means of an electronic data collection system. Eighty-eight percent of 6622 programs surveyed responded, with 83% reporting detailed information on residents. Analysis of graduate medical education data shows that the number of residents increased by 34.9% from the academic years 1980-1981 to 1990-1991, while the number of graduate year 1 residents decreased by 2%.

The annual surveys of residency programs on which this report is based have had a higher than 90% response rate for the 5 years previous to 1989. Because of a change to the new electronic data collection system in 1989, the response rate decreased to 78.3%. To adjust for the lower response rate, a regression model computed from data from previous years was developed that permitted projected estimates for 1989 data. These numbers are included in several key tables. The number of GY-1 positions seems to have decreased for 1990, although this may be an artifact of the response rate.

This is a case study illustrating the wide variety of models for rural health care delivery found in a western "frontier" state. In response to a legislative mandate, the University of Nevada School of Medicine created the Office of Rural Health in 1977. Utilizing a cooperative, community development approach, this office served as a resource, as well as a catalyst, in the development and expansion of a variety of alternative practice models for health care delivery to small, underserved rural communities.

A number of activities that would eventually change the field of continuing medical education (CME) occurred between May 1, 1988, and May 1, 1989. This report summarizes many of these initiatives, as well as updates ongoing CME activities.

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A relatively simple method for estimating the ability of rural communities to support health provider personnel services, the utilization of this tool is described and illustrated.

Healthcare professionals in the United States have been relatively unaware of the great interest in and experience with teamwork in health care going on in Great Britain and on the European continent. The author's reference to the famous call of Paul Revere, “the British are coming”, is not meant to imply that the British or their fellow Europeans are just arriving upon the scene, but, rather, that, in a more accurate historical sense, they have landed in force and are marching in well organized progression towards their objectives.

At the University of Nevada School of Medicine, medical students were introduced to community resources in their sophomore year. Studies strongly suggest that the physician who has some knowledge about a community agency, either through direct communication or through a patient's positive experience, tends to refer other patients to that resource.

In 1974, the University of Nevada, Reno, received a special health careers opportunity grant to fund the Health Careers for American Indians Program (HCAIP).  Aimed at increasing the number of Native American students enrolled in the university's model interdisciplinary health sciences program, HCAIP concentrated its first efforts on recruiting promosing high school students into a variety of health careers requiring university level training by means of a 6-week Summer Health Careers Program.

At the Forsyth Dental Infirmary, Boston, the orthodontist, pediatrician, nutritionist and child psychiatrist collaborate to promote a more comprehensive approach to the patient with malocclusion of the teeth. Each discipline contributes a special facet to the total clinical assessment of the child. The diagnostic conference serves as an important educational experience in the program of the postgraduate fellows in orthodontics.

Achieving the goals of health care reform – described by the Institute for Healthcare Improvement as the “Triple Aim” – will place new demands on the health care workforce. Interprofessional team-based care, quality and process improvement, and population health management are not skills that have been emphasized in traditional health professions education and training.