I was surprised by Pat Rich's recent article about support for changes to postgraduate medical education in Canada,1 as discussed at the CMA's annual general meeting in August 2003. The common first postgraduate year of training that is being proposed sounds very similar to the now defunct rotating internship, which provided young doctors with a broad-based, common first year of training. The rotating internship was abolished in the early 1990s, mainly at the prompting of the College of Family Physicians of Canada (CFPC). As I recall, the college insisted that once it moved to the 2-year residency system, the internships could not continue; the college wanted residency to begin immediately after the fourth year of medical school. This change removed the opportunity for young doctors to experience some “real medicine” and reassess their first choice of specialty before entering residency.
In 1993/94, I was one of those lucky enough to experience 12 months of rotations throughout the Maritimes, courtesy of Dalhousie University's valuable rotating internship. After my internship I wrote letters supporting internships2 and the position of my colleagues D.B. Craig and D. McKnight,3 who reported how difficult it was to fill anesthesia residencies without the rotating internships.
Now that the CFPC is lacking interested applicants, it wants to reintroduce the internship. On the surface I support this change — an internship is a phenomenal learning experience, ensuring that all physicians have some common knowledge and experience, regardless of the residency and area of practice that they eventually choose. But I'm doubtful about the CFPC's motives. If the college sincerely cared about giving residents the best overall training, would it have played such a crucial role in ending rotating internships?
Brent Kennedy Department of Anaesthesia Sudbury Regional Hospital Sudbury, Ont.
References
- 1.
- 2.
- 3.