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The introduction to this special issue of the Journal expands the scope of research on "the sociology of medical education" to include studies of the institutions in which physicians are trained as well as studies of the socialization of the physician throughout the life cycle. Research since the 1960s is reviewed briefly and the papers in this issue are discussed. Studies of the macropolitics and micropolitics of academic medicine are called for as well as comparative analyses of the settings in which physicians are trained and research on the relative effects on physicians' attitudes and behavior of different sets of experiences, professional and nonprofessional, over the course of their life cycle-all in the context of massive changes in the organization of health care. [ABSTRACT FROM AUTHOR]

Recent work on the sociology of the professions, in general, and on the profession of medicine, in particular, target dramatic changes in the organization of social institutions, "boundary work" among professionals, and the implications of both for professional power. However, public attitudes cited in theories as a critical linchpin of professional status remain relatively unexplored in the face of these changes and widespread contentions of public dissatisfaction. Using data from the 1976 National Survey of Access to Care (Aday, Andersen, and Fleming 1980) and the 1998 General Social Survey (Davis, Smith, and Mardsen 1998), we take advantage of a unique opportunity to compare the public's attitudes across a 20-year period. We examine individuals' evaluations of the way physicians do their work and their ability to confront health problems. Three findings support a complex view of public sentiments. First, while public confidence in physicians remains relatively high, we document a crystallization of attitudes reflecting greater negative and fewer positive sentiments. Second, while neither the structure of attitudes nor the role of sociodemographic characteristics in explaining attitudes has significantly shifted over time, in 1998 health status and insurance status are correlated with negative attitudes. Third, using General Social Survey time trend data on the confidence in medicine compared to other professions (science and education), we find support for a general public response to social institutions, with confidence in medicine tracking closely with confidence in science in level, and education in pattern. We end with four possible explanations of our findings, including and a general discussion of the role of the public in the professional status of physicians and its implications for social change in the institution of medicine. [ABSTRACT FROM AUTHOR]