Service vs Education

Glass et al (p 2651) describe a problem that exists in many if not all major teaching institutions. Residents are charged with performing a clinical responsibility without supervision, and when their performance of that responsibility is monitored, it is found to be suboptimum at best and incompetent at worst. The processing and reading of throat cultures is one of the bread-and-butter activities of the primary practitioner, given the prevalence of pharyngitis in the pediatric age group. Many practitioners, in an effort to save their patients money and to have early access to the culture results, perform these cultures in their offices. One might ask, where does the physician gain the expertise to process and interpret these cultures? Most will answer quickly that this was one of their responsibilities during residency training. And who taught them to process cultures during their residencies? If they were lucky, the microbiology technician took part