Internal medicine training in Nijmegen and Boston: observations from an American trained physician

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In July of 1992, I had the opportunity to spend two weeks at the University Hospital in Nijmegen to observe the training of internal medicine residents as well as the delivery of health care in the Netherlands. This visit occurred at the completion of my clinical specialty training in internal medicine at the Massachusetts General Hospital in Boston. My visit at the University Hospital in Nijmegen involved attending numerous clinical conferences, work rounds, teaching conferences and interacting with many residents and staff physicians. One of my first impressions was that both institutions place a very high priority on educating their residents to become outstanding physicians while helping these residents to deliver first rate health care to the patients. Nevertheless, the means to realizing these goals are often different, and at times these differences were dramatic.