To the Editor: Response to: Are We Preparing Residents for Their Actual Practices?

Carek and Mainous assert that residency training should focus on preparing physicians for their future practices.¹  The authors, however, sell short the value of broad training experience in preparing physicians for patient care. To properly train physicians, residency training should include patient encounters beyond the scope of future practice to ensure a complete understanding of common pathologies and provide exposure to career opportunities.

Comprehensive training provides residents with valuable exposure to the full disease courses they will manage and allows engagement with the entire spectrum of career prospects available within their specialty. Because all family medicine residents have some exposure to obstetric care, family physicians are better equipped to manage pregnant patients in the outpatient setting, with a more complete understanding of complications unique to pregnancy. Similarly, the experience of writing discharge summaries while managing an inpatient service prepares outpatient physicians to understand the hospital course of patients they see at transition-of-care appointments. Beyond a deepened understanding of different phases of various pathology, exposure to different areas of medicine can inform career choices as residents discover what parts of their specialty they truly enjoy. The authors point to a survey indicating that more than two-thirds of family medicine residents who had training in newborn hospital care, pediatric hospital care, and maternity care do not currently practice in these areas, but they discount the nearly one-third of those residents who currently do use these skills learned in residency.² 

While the authors' call for improved data of typical postgraduate practices is useful, caution should be exercised to avoid eliminating too many seemingly extraneous requirements. Residency training should not only prepare physicians for the most common fields within their specialty but also include exposure to other areas of medicine that will enhance their ability to provide appropriate patient care and find the niche within their specialty they are best suited to fill.