During the past 15 years there has been a remarkable renewal of interest in academic general internal medicine. Most academic departments of medicine now have divisions or sections of general or primary care internal medicine. There are political, social, economic, and, most important, medical reasons to account for the resurgence of the generalist. It is probable that these same forces will make the well-trained generalist the central provider and coordinator of health care services during the next several decades.
Despite these extraordinary developments, many questions that have been raised repeatedly during the past 15 years remain unresolved.1 These questions include the following: What should be the goals and objectives of a general medicine training program? How should programs develop, implement, and evaluate their educational objectives? How should these programs be integrated most effectively within academic departments of medicine? Are there unique roles for the general internist in the inpatient,