Balance in medical education networks.

Most graduates of U.S. medical schools will spend the number of years of residency training necessary for certification in a specialty. Essentially all of this graduate training, as well as undergraduate clinical medical education, is occurring in hospitals associated with the medical schools. The study reported here was undertaken to define the 112 medical education networks that offered 16,574 first-year residency positions in 1977; each consisted of a medical school and its associated hospitals. The balance between the numbers and sources of U.S. graduates who entered positions in each specialty for the first graduate year in the hospitals of each network and the kinds and locations of the residencies obtained by the graduates from each school was ascertained. These compilations were also made for each state. Marked differences were found among networks, states, and regions. The balance concept can facilitate the self-assessment by each state and network of its educational and manpower missions.