Journal of General Internal Medicine

, Volume 5, Issue 1, pp 34–41

Teaching humanistic and psychosocial aspects of care

Current practices and attitudes
  • William T. Merkel
  • Ronald B. Margolis
  • Robert C. Smith
Original Articles

DOI: 10.1007/BF02602307

Cite this article as:
Merkel, W.T., Margolis, R.B. & Smith, R.C. J Gen Intern Med (1990) 5: 34. doi:10.1007/BF02602307


To assess current practices and attitudes toward teaching humanistic and psychosocial aspects of care in internal medicine residency programs.

Design and participants: Survey questionnaires were sent to residency directors at all 434 internal medicine residency programs accredited in 1985–1986. Response rate for two mailings was 71%.

Measurements and main results: 78% of residency directors and 70% of department chairpersons bad high or moderately high levels of commitment to teaching bumanistic/psychosocial aspects of care, but only 44% of responding programs offered mandatory training, and only 18% offered elective training in these areas. Obstacles to expanded teaching of the bumanistic/psychosocial aspects rated high or moderately high by residency directors included insufficient curriculum time (51%), lack of trained faculty (44%), and pressures to reduce both training costs (40%) and patient-care costs (37%).

Conclusions: Most of the training that does occur in the humanistic/psychosocial aspects of care probably happens informally via mentoring and role modeling. Appeals to expand teaching in these areas raise questions regarding what to include in medical training and the proper scope of internal medicine. Sustainable change will depend on the politics of resource distribution and the influence of general internal medicine and primary care on traditional training.

Key words

education humanism internal medicine psychosocial residency training 

Copyright information

© Society of General Internal Medicine 1987

Authors and Affiliations

  • William T. Merkel
    • 1
  • Ronald B. Margolis
    • 1
  • Robert C. Smith
    • 2
  1. 1.the St. Louis University School of MedicineSt. Louis
  2. 2.Michigan State University College of Human MedicineEast Lansing
  3. 3.Division of Behavioral MedicineSt. Louis University Medical CenterSt. Louis