JAMA : the journal of the American Medical Association
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The performance of physicians in their day-to-day clinical practices has become an area of intense public interest. Both patients and health care purchasers want more effective means of identifying excellent clinicians, and a variety of organizations are discussing and implementing plans for assessing the performance of individual clinicians. In this article, we review the current state of physician clinical performance assessment with a focus on its usefulness for competency assessment. ⋯ We conclude that important technical barriers stand in the way of using physician clinical performance assessment for evaluating the competency of individual physicians. Overcoming these barriers will require considerable additional research and development. Even then, for some uses, physician clinical performance assessment at the individual physician level may be technically impossible to accomplish in a valid and fair way.
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Recent specialty choices of graduating US medical students suggest that lifestyle may be an increasingly important factor in their career decision making. ⋯ Perception of controllable lifestyle accounts for most of the variability in recent changing patterns in the specialty choices of graduating US medical students.
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To better provide medical students with the knowledge, skills, attitudes, and values they will need as physicians, US medical schools continue to make ongoing changes to their staffing and curricula. ⋯ While the number of applicants to US medical schools has continued to decline, student numbers are constant. The number of full-time faculty members has increased. Schools are incorporating new subject areas into their curricula, and the use of standardized methods of assessing clinical skills, while variable, is generally increasing.