ABSTRACT
To be practicing physicians, all medical school graduates must serve an internship. This mandatory year may be spent at a city, county, community, or university hospital, in either a specialized or a rotating program of training. The kind of hospital an intern selects determines the patients he will see as well as the teaching he receives from practicing physicians. At community hospitals, for example, interns see private rather than house patients. The internships students serve result, in part, from the students' preference for one or another medical career. Yet there are well-planned efforts to steer them in particular directions. In order to survive, specialty groups, medical school faculties, group practices, every subgroup of physicians must have new members. Some elite careers could grow out of a series of defaulting decisions and not elite aspirations or prudent choice and action. This chapter describes the first default that initiates the movement toward the elite medical careers.
