Findings from a study suggest that gaps exist in the preparedness of physicians to manage the full range of patients, procedures and problems they may encounter. A surprising one in 10 of medical residents said they felt unprepared to deal with such tasks as the treatment of HIV/AIDS, substance abuse, nursing home patients, management of chronic pain, counseling patients about domestic violence as well as about depression, and certain procedures, such as spinal or cancer-related surgery. “This survey tells us that residency programs may not be changing quickly enough to keep up with the reality of medical practice today. We may be seeing a residency-practice mismatch,” said David Blumenthal, lead study author, director of the Institute for Health Policy, Massachusetts General Hospital/Partners HealthCare System, and professor of medicine at Harvard Medical School. “Teaching hospitals and medical schools need to provide residents with quality training that reflects the diversity of the patients they will one day treat.” The study was conducted with support from the Commonwealth Fund Task Force on Academic Health Centers.