Search

The nature of the first year of postgraduate medical education has gone through many changes over the years. Relatively recent changes have made this first year into a specialty-specific experience. Medical students are increasingly experiencing a narrowed and less broad-based clinical education. Many students, residents, and attending physicians complain that they wish they had had a "rotating" or "flexible" internship. Graduate medical education authorities have recently recommended that the internship year return to a broad-based general medical education experience. In 1989, the authors surveyed the entire physician faculty and housestaff at a large academic health sciences center, asking them what type of first postgraduate year (PGY-1) the physicians had experienced themselves and what type of PGY-1 they recommended for future graduating medical students. Over one-third strongly recommended that the PGY-1 should be broad-based and not specialty-specific.

Injuries to front seat occupants in tow-away crashes in the Charlottesville, Va, area were compared for 1 year before and 1 year after Virginia's seat belt use law took effect. Vehicle and occupant data were combined to examine crash and injury patterns. Reported seat belt use in crashes increased after the law, and there were substantial decreases in injuries. Front seat occupants were less likely to receive medical treatment following a crash in the postlaw period. The reduction in the number of injuries was greater for passengers in the right front seat than for drivers and for frontal crashes than for other types of crashes. The injury reduction effects occurred primarily through reductions in the number of head and face injuries, particularly those that occur from contact with windshields and instrument panels.