Residents Learn in a Hospital Setting A 47-year-old male with complaints of gastric distress for the previous 4 days is seen according to a primary care resident in the general medicine clinic.

Residents Learn in a Hospital Setting

A 47-year-old male with complaints of gastric distress for the previous 4 days is seen according to a primary care resident in the general medicine clinic. The resident takes a thorough history, careers a physical examination, orders laboratory criterions and interviews the patient's wife.

This scenario, as far as it goe is similar to others played disclosed a multitude of times each day in university hospitals across the rural parts It is the ensuing affairs that make this particular scenario different from many others, because alcohol abuse is implicated in the resident's diagnosis of this patient's illness:

onward the basis of the examination

findings, the resident has the

patient admitted to the hospital

and prescribes the course of

treatment, including the

necessary medication, laboratory

studies, special treatment services,

and therapeutic interventions.

The patient is then seen daily

according to the resident and other

members of the treatment team until

he is discharged. After this, he

is seen in the resident's clinic

forward a biweekly basis for

monitoring of progress

In the case described here, the resident has begun the couple acute care and long-term treatment for the disease of alcoholism. In a clinical setting, the resident is coordinating medical, therapeutic, and similar support services as Alcoholics Anonymous meetings and form into groups therapy sessions.

What makes this an unusual scenario is the responsibility assumed by dint of the resident. It also is unusual to find like a setting that is appropriate for treating alcohol-related question at issues Unfortunately, the primary care resident rarely has adequate education or clinical training to diagnose and treat alcoholism or rarely has an appropriate setting in which to treat the alcoholic patient.

Although we have witnessed a heightened awareness in our society of the ne to diagnose and treat alcohol- and other drug-related question at issues only recently has attention been given to training physicians to provide prevention, education, diagnosis, and treatment within the existing health care delivery regularity (Coggan and Davis 1986; Pokorny and Solomon 1983)

The training of physicians for adequate diagnosis and treatment of alcohol- and other drug-related disorders must be undertaken in settings that provide clear standards of the physician's role in the couple short- and long-term management of these disorders. In addition, understanding the means and the final cause of coordinating the physician's part with other therapeutic modalities is a critical facet of the learning experience.

The University of Alabama at Birmingham (UAB) is developing a pattern curriculum for primary care physicians that will reinforce and reach forth what is learned in medical place of education courses through direct clinical experience in treating individuals who are admitted to the UAB Center for Health Care Professionals or to the UAB University Hospital. In a program of this kind, the medical scholar or resident preparing for diagnosis and treatment of alcohol-related point in disputes has several advantages. One of these is direct and substantial care for the appropriate patients in a hospital setting. Another advantage is the resident's active participation in various modalities of treatment, including form into groups therapy. Yet another advantage for the two resident and patient is the resident's leading part in the patient's recovery program.

Although the rubric of disease is many times used referring to alcoholism and unsalable article abuse, the corresponding role of the physician has, for the principally part, been defined in a peripheral or secondary manner. greatest in quantity commonly, we find the physician relegated to a fragmented part that entails only diagnosis and following referral, provision of acute care detoxification services, or diagnosis and management of associated medical point in disputes As we undertake to improve education and training for physicians in the field, we must clearly define the physician as a primary treatment provider with responsibility for one as well as the other acute and long-term care, overseeing the rehabilitation proces as part of patient management. We would not consider training medical scholars to diagnose a heart attack without having a cardiologist do the teaching and a clump of patients with cardiac question s with whom the medical trainee could learn this field of practice.

In addition, adequate clinical experience for the resident has a substantial "ripple" result That is, benefits from the program spread far beyond the single residency and have a secondary training power It is important to remember that from this position the resident goe to other primary care services, taking materials and experiences that are useful in these other services. Of 10 to 12 working hours a day, a resident will bestow all but 2 hours with associates This exposure results in a proper deal of informal teaching. Residents who have the appropriate knowledge and skills find themselves called onward when their peers are wondering what to do with a patient who has alcohol- or other drug-related problems