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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]

This paper explores the effects of computerized medical information systems on the occupational communities of health care professionals in hospitals. Interviews were conducted with informants from the pharmacy and nursing departments at two hospitals currently using medical information systems for communicating physicians' medication orders from the nursing station to the pharmacy. Results showed changes in tasks for both pharmacy and nursing, resulting in increased interdependence between the two departments. This interdependence was accompanied by improved communication and cooperation, providing an opportunity to encourage better working relationships between departments. The use and maintenance of the common computerized data base became a superordinate goal for the two groups, with the computer system itself as the topic of communication. [ABSTRACT FROM AUTHOR]

Using recent first-hand accounts by Klass (1987), Konner (1987), LeBaron (1982), and Reilly (1987), this paper examines "insiders' "experiences of medical school. Medical education emphasizes disease, technical procedures, and technological medicine, with scant attention to "caring" aspects of doctoring. Students struggle to learn medicine and to maintain a humanistic or patient-oriented perspective, but the social environment of medical training militates against humanistic doctoring. Toward the end of medical school, students undergo a transformation by adopting the medical-clinical perspective and shifting their identification from patients to doctors. The doctors who maintain a humanistic orientation to medical care appear to be individuals who had developed this orientation before they arrived at medical school. Thus, to increase the number of humanistic physicians, the best strategy may be to alter medical school recruitment and selection policies. [ABSTRACT FROM AUTHOR]

This paper examines changes the structure of the medical profession in Finland. Using questionnaire data from 93 per cent of the total population of Finnish physicians, the consequences of these changes, both for the physicians and for the country as a whole, are discussed. [ABSTRACT FROM AUTHOR]

This article comments on the article "Processes of Continuity and Change During Socialization for Medicine in Israel," by Judith T. Shuval and Israel Adler, in the 1977 issue of the "Journal of Health and Social Behavior". Shuval and Adler are concerned with the processes by which the normative image of the physician changes and develops over time during socialization for medicine. However, the authors have presented a groundless theory. It is a theory based neither on experience nor on some logical framework, having no explicit statements and having only one very vaguely understood concept, socialization, which functions as the guiding metaphor for their study.

The relationship between physicians and physician extender occupations is considered in light of the stratification of medical care workers. Professional dominance between various medical occupations and professional competition among physicians are considered. Data from a national sample of physicians taken in 1981 are used to determine 1) under what conditions physicians are likely to consider the employment of physician extenders helpful for improving quality of care and 2) which characteristics and available resources are associated with the belief that the employment of physician extenders will improve medical care. Of four different service populations considered, physicians are most likely to think that the use of physician extenders to care for the urban poor will aid care and are least likely to think that their employment will improve care for obstetrics and pediatrics cases. The results indicate that physicians' beliefs regarding the employment of physician extenders are dependent on the clientele as well as on the relative position of the two occupational groups in the hierarchy of medical care occupations. [ABSTRACT FROM AUTHOR]

Although both gender and professional socialization determine physicians' values, attitudes, and behaviors, the relative importance of each varies. Physicians' career paths demonstrate gender differences: women tend to choose primary care fields and rarely enter surgery, they are paid less and are less likely to be self-employed, and they are underrepresented in positions of authority within medical organizations and in academia. Data on practice style reveal striking similarities in physicians' attitudes toward patient care, knowledge, and clinical behavior, but recent work on physician-patient communication reveals important gender differences. These differences suggest that although medical socialization determines most aspects of practice style, a physician's gender can have an important influence on medical practice. [ABSTRACT FROM AUTHOR]