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• W2021305621 abstract "William Osler was not the first clinician-educator, but he established the tradition in North America.1 Interestingly, his students worked in the outpatient department at Johns Hopkins University.2 They were expected to evaluate and present their patients to Osler, and to follow them longitudinally. Osler appears to have placed great weight on the students getting to know their patients. Each student had a handful of patients and made housecalls. On the inpatient services, a team of residents and students worked under Osler or a member of his staff. Residents were semipermanently employed, and were more like junior faculty than the residents of today. Each resident had an assignment, such as work in the bacteriology or chemistry laboratory, or interpreting pathology specimens.2 If present-day generalists feel stretched, so it seems were their colleagues of a century ago, who were expected to master fields now considered to be far separated from internal medicine.The system of learning from cases under the directorship of a professor and his staff apparently replaced a loose apprenticeship system, and was consistent with the Flexner report. Osler's system still remains in place, influenced by the pressures of modern practice. But the remarkable strength of this system reflects its core virtues. We postulate that these core virtues are principles of adult learning, which is collaborative, involves actively solving problems, and is readily applicable to the future work of physicians. While medical learning over the following decades became firmly hospital-based, shortened lengths of stay with rapid turnover of patients in hospitals are beginning to truncate this learning. New trends, however, promise a new horizon, shifting the focus of learning to the outpatient setting. The trends, which seem inexorably in place, include treating the majority of everyday medical problems cost-effectively within outpatient settings, the consequent expansion of outpatient practices affiliated with academic centers, and the availability of large numbers of clinical faculty as teachers. These are the new clinician-educators, recruited to staff outpatient practices. The trend toward generalism is also clearly in place.3–8 Because the new practices are built around comprehensive primary care delivered by generalists, the most pressing need is to train future generalists, not only in larger numbers, but also more comprehensively.9 Clearly, there are magnificent opportunities now to bring the finest traditions of clinical teaching to the outpatient setting. There are also formidable obstacles that must be overcome. To a large extent, success depends on developing faculty as clinician-educators to carry out this task." @default.
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• W2021305621 title "The clinician-educator—Present and future roles" @default.
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• W2021305621 doi "https://doi.org/10.1046/j.1525-1497.12.s2.16.x" @default.
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