I read with interest the article in the Archives regarding the exposure of internal medicine trainees to gynecology and obstetrics.1 One question that was not addressed in detail was the reason that the educational process was deficient in these areas. As an internist who is frequently called on to act as a patient's provider of gynecologic care, as well as to consult on medical problems in obstetrics, I can appreciate the problem of teaching our future colleagues the skills that they will need. My experiences in training may shed some light on some of the problems involved.
I was fortunate to attend a residency program where stress was placed on acquiring these skills. In our resident's clinic, we were not allowed to refer a patient to the gynecologic clinic for examination unless cleared by an attending physician. This forced us to become adept at gynecologic examination. In addition, a