Through the use of questionnaires and interview schedules during extended site visits, sixteen programs training residents in non-family medicine primary care were studied to determine what factors contributed to program success -- known as "institutionalization" -- or to program failure. The findings revealed that programs were initiated for either philosophic or pragmatic money reasons. For programs to begin, to continue, and to be institutionalized was due to several contributing key factors. These included the resolution of programmatic differences in regard to goals; development of a substantive quality program; presence of forceful and respected leadership; tangible support of the administration and key academic departments; commitment of the teaching staff; anticipation of potential conflicts; participation of the involved lay and professional community; and the availability of some continued funding. The study also revealed that one program was a complete failure and had to be aborted because none of the key factors were present. The study concluded that the best way for institutionalization to occur is to assure that sound and comprehensive planning takes place. With thorough and anticipatory planning, the conditions essential to program institutionalization can be met more easily.
Internship and Residency Primary Health Care