Academic medicine : journal of the Association of American Medical Colleges
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The term academic continuing medical education (CME) is defined and explored from the perspective of forces that have made its usage necessary. These forces include the new understandings of the place, impact, and scope of CME, and, in particular, the increasing entrepreneurial interests in the field, unrelated to the improvement of physicians' competence or performance, or to health care outcomes. In addition to principles of CME provision promulgated by the Accreditation Council of CME, and those of ethical CME providers, academic CME implies the critical appraisal of the providers' activities, the creation of new knowledge about how physicians learn and change, and the dissemination of information based on such knowledge. Finally, the nature of academic CME providers is discussed, and the potential role of CME in fostering the social contract between the medical professional and society is explored.
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The authors reviewed 136 cases of malpractice litigation involving residents or programs of graduate medical education that were reported from 1950 through 1989. Before 1970 malpractice constituted the only area of reported litigation for residents. The number of malpractice cases involving residents increased substantially after 1975, paralleling the growth of malpractice cases nationally. ⋯ Questions related to judicial procedure, immunity from liability, breach or causation, and informed consent were also litigated. Residents were on the side of the prevailing party in 44% of the cases. Malpractice continues to be the key legal issue facing programs of residency training.