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According to the Bureau of Labor Statistics (cf. Crispell, 1990), the medical clerical field is one of the faster growing areas of employment. This paper reports on long‐term employment of trainees involved in nontraditional medical clerical programs. These programs were funded by the Job Training Partnership Act (JTPA) and filled both the needs of the local rural health care facilities and the employment needs of unskilled youths and adults. These nontraditional students of low socioeconomic background and poor work history were successfully mainstreamed into university courses and consequently obtained productive employment. A follow‐up study was conducted of 64 individuals who completed three different, one‐year JTPA programs. The study investigated the following questions: Was the trainee currently employed? If so, was employment related to the training program, and were the quarterly salaries higher than minimum wage and previous salaries? How many different jobs were reported since training? Did the individual retain employment in a rural setting? The JTPA programs at Southern Illinois University included some innovative yet practical components that resulted in very high program completion rates, high initial placement, and a continuing pattern of long‐term employment. These components included: emphasis on training for the most needed positions/jobs that matched university capabilities; the pursuit of higher starting salaries; informing participants of support services; training in job hunting and work readiness; using some individualized, competency‐based instruction; establishing internship arrangements with prospective employers; and careful matching of the trainee to initial placement site with consideration of personality as well as skills. Copyright © 1992, Wiley Blackwell. All rights reserved

[No abstract available]

1991 marks thirty years of formal education in occupational therapy in Western Australia. From its humble origins in an old hotel, the undergraduate occupational therapy programme in Western Australia has evolved from one which had a very strong vocational focus, was largely steeped in medical traditions and which had an emphasis on teaching technical skills, to one which is more academic and outward looking in its orientation. However, as we enter the 1990s undergraduate education in occupational therapy must face the challenges associated with the National Training Board's move to competency‐based standards and assessment in the workplace. This study of historical material compares the three major stages of development in the thirty years of undergraduate education in occupational therapy in Western Australia. Reflection on these developments may guide future directions in undergraduate education and result in outcomes which will equip occupational therapists for leadership in the provision of health services. 1991 Occupational Therapy Australia Limited

Directors of pediatric residency programs in the United States, Puerto Rico, and Canada were surveyed regarding plans of graduating residents to determine whether new pediatricians experienced problems finding employment in light of a decreasing growth rate in the child population. Nearly 90% of directors responded, providing information on 1915 residents. Of the 1782 nonmilitary residents in the United States, 815 were entering general pediatric practice and one third (596) were entering subspecialty training. Nearly one half (379) of residents entering general pediatric practice were joining a small group practice, almost one fourth (184) were joining a larger group, 6% (48) were becoming solo practitioners, 7% (57) were joining a health maintenance organization, and nearly 8% (62) were joining a hospital or academic staff. Most residents in the United States experienced no difficulty finding a position and received multiple offers for jobs. Canadian residents were similar to residents in the United States, whereas the postresidency situations of graduates of military and Puerto Rican programs were very different. Despite manpower predictions to the contrary, comments by program directors indicated a demand for general pediatricians. This paper presents only the viewpoint of program directors; whether this perceived need illustrates an avid market for young general pediatricians merits further study.

The 'Forderungslehrgang' in our asthma center is a special training program for adolescents handicapped by asthma or allergic diseases who are therefor not able to start apprenticeship. The course takes one year. Besides vocational guidance and try-out of different occupations, medical and psychological diagnostics are performed. Medical service is provided all day, and a hospital with emergency unit is within the area. Though 41% of the participants did finish school without any qualified graduation after their compulsory school attendance, 79% were able to start apprenticeship after the course.

This is a continuing series of objectives to direct resident training in emergency medicine. Electrocardiography may not receive individual attention in many training programs. However, the importance, omnipresence, and medicolegal potential of electrocardiography in the practice of emergency medicine suggests its individual attention. Contents and specific learning objectives are presented to provide guidelines for resident mastery, following the format presented by preceding subjects. © 1991.

Most future medical leaders receive little or no formal exposure to management and leadership training activities. Industry invests considerable resources in such training for middle and senior level managers. With the increasing complexity of health care delivery systems and the increased involvement of diverse teams of individuals in the care of patients, it was believed that a training activity designed to enhance participant human interaction skills and teach about group behavior and team management might be valuable to pediatric chief residents. This article describes a 3-day workshop designed to develop such leadership skills. It has been conducted for 3 years with 117 participants. Results of end-of-course and 6-month follow-up evaluations show that participants enjoyed the training experience and believed it was valuable in helping them fulfill their leadership role as chief resident. © 1991, American Medical Association. All rights reserved.

Although a few surgical residents do leave the surgical field, little research has been done into the eventual whereabouts of all surgical residents. We undertook this follow-up to find out what proportion of them enter the surgical field and to identify changing patterns over the past 15 years. We compared 593 medical schoool graduates on demographics, academic credentials, and surgery program directors' rating of their performance in the first postgraduate year (PGY-1). Sixty percent remained in general surgery, and about 26% moved to another specialty within the surgical field. During the mid-1970s, those who remained within the surgical field had better academic credentials on average than those who switched out of the surgical field. However, more recently, the trend has reversed. There were no differences between the groups on age or sex. These results suggest that some good students are being recruited into surgical programs but are later lost in major career switches. Perhaps these changes are related to residents' preferences for specialties that offer more controllable lifestyles than the surgical field. © 1991.

To test the hypothesis that a program of regular reading and discussion would result in significant improvement in the surgical database as measured by the American Board of Surgery In-Training Examination (ABSITE), we conducted a 2-year prospective study. The study group, which was comprised of 40 residents, was compared with a control group of 44 residents enrolled in the residency during the 2 years that preceded the study period. Neither reading effort nor discussion group attendance correlated strongly with ABSITE performance among first-year residents. At this level, ABSITE scores correlated best with National Board of Medical Examiners Part I scores (r = 0.699, p = 0.002). In contrast, second-year through fifth-year residents showed a cumulative improvement across the residency (80 versus 180 standard score points, p = 0.048). Individual resident improvement correlated highly with reading effort (r = 0.79, p < 0.001). There was little measurable effect from attending discussion sessions. We conclude that the surgical database can be improved by a program of regular reading and that the magnitude of the improvement is directly proportional to the reading effort. © 1991.