MKSAPIV: A Professional Commitment WHAT is a profession?

. . . a calling requiring specialized knowledge and often long and intensive preparation including instruction in skills and methods as well as in the scientific, historical, or scholarly principles underlying such skills and methods, maintaining by force of organization or concerted opinion high standards of achievement and conduct, and committing its members to continued study and to a kind of work which has for its prime purpose the rendering of a public service . . . (1) We in American medicine are a profession. Judged against medicine and nations in half of Europe and much of Asia, we are still a free profession in a nation of free men. We are not under the thumb of a tyranny disguised as a "peoples' democracy" that is no democracy. Our commitment "to a kind of work which has for its prime purpose the rendering of a public service" was freely made and is freely continued. But this freedom has the price of responsibility. Several of the editorials in our Bicentennial series have looked at some of these commitments and how we must reaffirm them in action if we are to be considered still a profession. In "Medical Licensure and Professional Discipline" (September issue), Robert Derbyshire called for effective means to bring "force of organization" to maintain "high standards . . . of conduct." In "National Health Policy" (p. 000 of this issue) Jesse Steinfeld calls for new efforts for our "prime purpose," "the rendering of a public service." In "Graduate Medical Education" (August issue), Philip Lee asked for more support to "intensive preparation" for primary care. Up to a decade ago, "high standards of achievement" meant clearing the barriers of graduation, licensure, and board certification, with no subsequent uniform tests of professional knowledge and skill. With its first Medical Knowledge Self-Assessment Program (MKSAP I), the American College of Physicians showed in 1968 what a free profession in a nation of free men could do to set its own standards for continued study and achievement in the years after those tests of entry into the profession. This first Self-Assessment Program was subscribed to by 12 000 physicians. The Program quickly became the model for Editorials and Notes

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similar programs in other fields and other countries. In 1971, 19 000 physicians took part in MKSAP II; in 1974, 29 000 in MKSAP III. In August of this year, a detailed announcement of MKSAP IV went out to the 35 000 members of the College and 110 000 other physicians. The new program has many features that strengthen its value for self-teaching, beyond its value as a test of one's knowledge in internal medicine. MKSAP IV is available to all physicians, not only members of the College. Requests for information on the content and price of the Program should be addressed to MKSAP IV, American

College of Physicians, 4200 Pine Street, Philadelphia, Pennsylvania, 19104 (U.S.A.). The Syllabus for the Program will be mailed very soon, and the Self-Assessment will be mailed at the end of May 1977. Do not delay in requesting the description of the Program and then in sending in your order.—The Editor Reference 1. GOVE PB (editor-in-chief): Webster's Third New International Dictionary of the English Language Unabridged. Springfield, Massachusetts, G. & C. Merriam Company, 1961, p. 1811

Historic Documents in American Medicine

Viral or Mycoplasmal Pneumonias—1939 Instead of customarily classifying the cases observed as "colds" and pneumonia separately, the epidemic was looked upon as composed of a disease entity caused by a single infectious agent. .. . The mildest cases with rhinitis or pharyngitis were presumably in those with the greatest resistance, as compared with severe cases with involvement of most of the respiratory tract including the lungs.. . . Roentgenographs evidence of tracheobronchitis or pneumonia was present in 71 of our patients. . . . A similar form of bacteria-free, mononuclear cell, interstitial pneumonia was found in animals inoculated with a virus obtained from our patients in 1938. [1] In retrospect, on clinical and epidemiological grounds, the 1937 infection was probably mycoplasmal; the one in 1940, of viral origin. Publications reporting the matter . . . appeared before the disease became pandemic during mobilization and activity of the Armed Forces in World War II. Distinguishing nonbacterial from bacterial pneumonias clarified diagnoses and obviated unnecessary antimicrobic therapy. [2]

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1.

HOB ART A. REIMANN and JOSEPH STOKES, JR. A Newly Recognized entity. An Epidemic Infection of the Respiratory Tract in 1938-39. Transactions of the Association of American Physicians 54:123-127, 1939.

2.

HOBART

A.

REIMANN

The Pneumonias, Philadelphia, F. A. Davis Co., 1971, p. 85.

November 1976 • Annals of Internal Medicine • Volume 85 • Number 5

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MKSAP IV: a professional commitment.

MKSAPIV: A Professional Commitment WHAT is a profession? . . . a calling requiring specialized knowledge and often long and intensive preparation inc...
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