Many young physicians completing residency training in primary care specialties do not feel prepared to counsel patients in areas such as depression, substance abuse and domestic violence, according to a report from the Institute for Health Policy at Massachusetts General Hospital (MGH). The researchers present their analysis of survey responses from residents in family practice, internal medicine, and obstetrics and gynecology in the May issue of the Journal of General Internal Medicine.

"Residents may have the knowledge and skills required to provide this kind of counseling, but when actually called on to do it, they may not be completely comfortable," says Elyse Park, PhD, the MGH psychologist who led the study. "They also may find it hard to bring up such matters in patient visits that have so many competing priorities and time constraints."

The study examined data from a comprehensive survey of medical residents taken in 1998 with the support of the Commonwealth Fund Task Force on Academic Health Centers. The overall survey compiled responses from more that 4,800 residents completing training in eight specialties at programs across the country. The current report analyzes the responses of more than 900 residents in the three specialties that focus on adult primary care internal medicine, family practice and obstetrics/gynecology to questions about how prepared they felt to counsel patients about smoking, diet and exercise, substance abuse, depression, and domestic violence.

While almost two thirds of the residents felt well prepared to advise patients about smoking and diet/exercise, less than half reported feeling well prepared to deal with issues involving depression, substance abuse and domestic violence. There were some differences by specialty, with the obstetrics/gynecology residents feeling better prepared to discuss domestic violence and family practitioners more confident in addressing depression. Although the
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
9-May-2005

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