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Letters to the Editor  |   September 2004
Bridging Perspectives, but Regretting Demise of Internship
Author Affiliations
  • John J. O'Connor, MD, FACS
    Suburban Hospital Bethesda, Maryland
    Attending Surgeon
Article Information
Medical Education / Professional Issues
Letters to the Editor   |   September 2004
Bridging Perspectives, but Regretting Demise of Internship
The Journal of the American Osteopathic Association, September 2004, Vol. 104, 365-366. doi:10.7556/jaoa.2004.104.9.365
The Journal of the American Osteopathic Association, September 2004, Vol. 104, 365-366. doi:10.7556/jaoa.2004.104.9.365
To the Editor:  
I read with interest the letter by Adam B. Smith, MSIV, and the response by Michael I. Opipari, DO, reflecting on the philosophy of internship (J Am Osteopath Assoc. 2004;104:230, 231, respectively). I agree with the authors that the vagaries of state licensure prevent the medical profession from exerting control in the type of licenses issued, as well as how and where issuing occurs. The medical student, Adam Smith, makes a good point when he notes that an internship at that stage of training seems redundant and a waste of a year just so that one can gain access into his chosen specialty sooner. However, I believe there are many points to be made about the value of an internship, and I am sad to see that it has virtually disappeared from the medical landscape. 
The internship, particularly the rotating internship, provides new medical school graduates with the opportunity of having minimally supervised care of patients that is not reflected in their medical school training. This opportunity provides the time needed to gain both diagnostic and therapeutic skills, as well as exposure to disciplines that physicians entering specialty care may never encounter again. 
As a subspecialist, I find nothing more frustrating than to have a patient referred to me by a well-intentioned primary care physician who has no concept of the disease processes with which I am dealing, nor the therapeutic modalities that are available. In such a scenario, patients may also be given misinformation or, worse, poor advice. Therefore, another valuable result of the internship is that it allows new medical school graduates time to gain a better understanding of the medical specialties and therefore to make a logical choice as to which specialty they wish to enter. 
The most important result of having completed the internship is that it gives the new graduate time to develop communication skills that may be used when interacting with patients, colleagues, and the community at large. As physicians gain time in practice, communication skills learned during their internship may help to prevent them from being engaged in a malpractice situation. 
I agree with the premise of both gentlemen's letters about this difficult question. In any case, I sincerely wish soon-to-be Dr Smith the greatest luck in his chosen profession.