To the prospective residency applicant:

Since the 1960s, when the discipline of family practice was created, the health-care climate has changed greatly. At that time the public had begun to react negatively toward the perceived fragmentation and technological obsession of subspecialty medicine. The public had also become increasingly sensitive to both the shortage of primary care physicians and the serious inequities in the distribution of their services, particularly to poor and minority communities. Today, on the other hand, federal, state, and even municipal governments in the United States are challenging the longstanding social commitment to providing a "safety net" of health services. Increasingly, family physicians caring for the underserved are confronted with sicker patients while government programs are shrinking and prospects for universal health care are slim.

At the same time, academic medical centers are reorganizing in response to the radical changes in the "health industry." New York Hospital and Presbyterian Hospital, two of the leading teaching hospitals in the New York metropolitan area, merged in 1998 to form New York-Presbyterian Hospital. In addition to world renowned research and quartenary clinical care, the merged hospital provides approximately one million ambulatory care visits annually.

Among the managers of health care, the importance of primary care and preventive services is gaining greater recognition. The influence of managed care has drawn primary care physicians from the periphery of the provider system to its center. Concurrently, much of primary care methodology is being reexamined from a more critical, scientific perspective. Family medicine, the academic branch of the clinical discipline known as family practice, is examining relevant primary care issues and conducting research to provide meaningful answers.

Such is the climate in which the Family Medicine Residency Program at the New York-Presbyterian Hospital: Columbia University Medical Center exists. The program is committed to training physicians who want to acquire the special skills needed to care for families, particularly those families with problems unique to urban communities. It also strives to teach its residents to develop systems that improve the health of whole communities, to motivate them to teach family practice to fellow practitioners, and, fundamentally, to inspire them to create change. In short, the Family Medicine Residency Program is recruiting and training leaders for tomorrow's health care.

After reviewing this description, feel free to call with questions. For those of you who, after reflection, feel that this program is right for you, please apply. We look forward to meeting you.