In 1971, the Department of Physical Medicine at Ohio State University accepted 6 students directly after graduation from medical school into a 3 yr integrated internship residency program. The incoming residents had 6 mth of conventional internship experience in a local community hospital and then 2.5 yr of training in physical medicine at various hospitals. The authors have now further modified the program so that the entire first year of postgraduate training is spent in a university affiliated community hospital with a comprehensive physical medicine department. These changes were made to permit the new physician to make a gradual transition from medical school to specialty training and to provide an initial exposure to physical medicine in an acute hospital setting. This approach has permitted young physicians in the integrated program to have sufficient postgraduate training in internal medicine as well as an introduction to rehabilitation medicine and to develop a strong identity as physiatrists during the first year after graduation from medical school.
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