Why Are There Intern “Boot Camps”?

A concept that has been percolating in the medical literature boiled over into the mainstream as the New York Times published this story, “Chicago’s Intern ‘Boot Camp’ ” is a rehearsal for life or death medical issues.” The article describes a new internal medicine intern having to deal with a simulated patient who is critically ill and has alarms flashing. Another intern had to tell a “patient” played by an actor that he had terminal cancer. The performances of both of the young doctors were evaluated by instructors. The 81 interns in the program must “pass graded tests in procedures and communication skills before being allowed to move ahead.” The boot camp described in the Times piece was the subject of a paper published in Academic Medicine earlier this year. It concluded that “Boot-camp-trained interns all eventually met or exceeded the MPS [minimum passing standard] and performed significantly better than historical control interns on all skills (P < .01), even after controlling for age, gender, and USMLE Step 1 and 2 scores (P < .001).” Here is how the Mayo Clinic describes its boot camp for fourth year med students, “An intensive 1-week course, Internship Boot Camp has simulated, longitudinal patient-care scenarios that use high-fidelity medical simulation, standardized patients, procedural task trainers, and problem-based learning to help students apply their knowledge and develop a framework for response to the challenges they will face as interns.” They compared survey results from students who had done the boot camp to those who had not and found the boot camp prepared students for internship better than conventional sub-internships did. Similar “boot camps”...