Volume 65 Number 4 September 1998	back to contents

Impact of the Libby Zion Case on Graduate Medical Education in Internal Medicine	296
Jeffrey M. Brensilver, Lawrence Smith, and Christopher S. Lyttle

ABSTRACT
Residency training in New York State was substantially altered by the Libby Zion case. Work- hour limitations and augmented supervisory requirements changed the patterns of training -- particularly in internal medicine -- but with uncertain impacts on the quality of education and patient care. In this historical analysis, we review another major effect of the case: a substantial augmentation of the number of trainees. The need to maintain adequate inpatient staffing -- within the ground rules of the Residency Review Committee, and in consideration of the reimbursement formulae and financial climate of New York State -- conspired to promote substantial residency program expansion. Similar forces contributed to a national trend to increase the number of trainees. The history, cost and impact of these personnel changes are reviewed.

KEY WORDS
Graduate Medical Education (GME), training, manpower

MSSM Home

Back Issues | Indexes | Search | Journal Home