Internal medicine residency program violations of the minimum autopsy rate.

To the Editor. —Dr Campman 1 sends a compelling message: in spite of the documented value of autopsies, physicians are not requesting them and pathologists are not performing them. The Residency Review Committee for Internal Medicine recognized this problem by requiring autopsies in at least 15% of deaths on the medical service in accredited residency programs. Residents also must be notified about autopsies performed on their patients and should attend them, and pathological material should be used during formally structured subsequent teaching sessions. Despite these rigorous requirements, we now have evidence to support Campman's conclusions: from January 1991 to May 1994, 51% of 386 internal medicine residency programs reviewed for accreditation were cited for violation of this particular standard (Table). Clearly, the educational community in internal medicine has not convinced its constituents of the value of autopsies. Even the risk of an important citation, which might lead to an adverse