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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.

Proposed changes in physical therapy clinical education have been generated from data collected from the three key populations: academic faculty members responsible for clinical education; clinical faculty members, and students about to enter their full time phase of clinical education. Proposed changes include a change in terminology from clinical education to internship. The internship is proposed for a mean period of 6 mth. It is to be directed and provided by a primary institution with possible satellite institutions. Learning experiences would be provided in the major physical therapist roles including direct patient care, consultation, teaching research, and administration. The curricula would be flexible and allow for individualisation for each participating institution and intern. A stipend or minimum wage for the intern is recommended with consideration of tuition being paid to the internship institution. This proposed internship is to replace the present full time clinical education.

The education of physicians and other health personnel in a medical center for the care of the elderly is intimately linked with the provisions for the delivery of health care within the center. The educational process is not limited to the school of medicine or other academic components but includes internship and residency programs. Aging is of concern to almost all teaching departments of the school of medicine and an isolated department of geriatrics cannot provide medical students with all the information they require. This demands the cooperation of the specialties.

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