Medical education and postgraduate training in the USA: special reference to children's hospital.

The American medical education from undergraduate to postgraduate education is introduced. All physicians and surgeons require residency training before becoming eligible to be certified by the American Board of Medical Specialty. The residency program is tightly overseen and regulated by the Accreditation Council for Graduate Medical Education (ACGME) and the Residency Review Committee in order to maintain its quality. The American healthcare system with its current trend towards managed care is also presented. Managed care has changed the scope of American medical education. Medicare and Medicaid have been the primary source of funding for graduate medical education (GME). With these governmental health insurance programs now involving managed care, GME funding has been reduced. Uprising of managed care is followed by a strong emphasis to train more primary care physicians than specialists. The current trend in child health care is moving towards decreased hospitalization, increased ambulatory care and increased community-based service.