A group-based training programme for general practitioners: a Norwegian experience.

There are approximately 3000 general practitioners in Norway, serving a population of slightly above four million people. A three year postgraduate education scheme for general practitioners has been in effect since 1973, to be replaced by a five year vocational training programme from January 1985, making general practice a fully recognized specialty from that date. The educational requirements consist of one year of hospital training, four years of training in general practice, and a total of 400 hours of course education, mainly in clinical subjects. The core element of the training is attendance at a group-based structured educational programme of two years' duration. This article describes the concepts and content of this decentralized group-based education, as well as some of the conflicting considerations which eventually led to this new Norwegian model of general practice training. The first evaluation studies indicate that the educational programme has met a long standing need among general practitioners.

Patient management problems in general practice using a medical journal for self-assessment exercises.

A series of six patient management problems, with clinical case histories from the authors' own practices, was presented in a Norwegian medical journal (Utposten) during 1981 and the spring of 1982. The readers were asked to respond to a number of statements which related to each case history, using a 5-point rating scale. The answers were prepared from return forms mailed anonymously to the authors, leaving the doctors with copies of their own answers. The following issue of the journal then presented the distribution of all incoming answers by giving histograms and mean values of the ratings for each question. In addition, the case history author gave his own ratings, a review of the answers, and more details about the case. In this way the respondents were given a possibility of comparing their own diagnostic skills and management decisions with those of their colleagues. There was a total of 406 incoming answers from 243 different participants, among whom 210 were general practitioners or district physicians. Background characteristics of these doctors are discussed, as well as the results of an evaluation questionnaire. This experiment with problem solving by mail was well received by the readers, mainly as a supplement to their continuing medical education. The method in this study, which permits quantification of clinical decision, may be a useful tool for medical audit activities.