To determine if there might be differences in specialist and generalists' teaching effectiveness, student scores on an objective, structured, clinical examination (OSCE) were compared. Finally, we compared small group grades assigned by specialist and generalist leaders to their students. RESULTS: Responses from 77% of the students indicated that specialists and generalists teach basic examination skills with equal effectiveness. Responses from 71% of the leaders indicated that they are equally confident in teaching basic examination skills. There were no differences in the generalists and specialists assignment of grades to their students. Most importantly, there were no differences in the scores on the OSCE between students taught by generalists and specialists. CONCLUSION: Medical schools can expand their pool of physicians teaching basic skills by utilizing specialists without decreasing teaching effectiveness. With changes in the organization, financing and delivery of health care, this strategy could help schools preserve their academic mission in the face of mounting pressure to increase clinical revenue. Novel point-of-care echo machines are becoming available and may provide a rapid and cost-effective method for accurately assessing LV function. It is unknown, however, whether physicians without prior echo experience can be trained to use echo to assess LV systolic function. METHODS: Physicians, without prior echo experience, completed a 3-hour training course including didactic and hands-on training in echocardiography. Patients scheduled for standard transthoracic echocardiography as part of their clinical care were eligible for enrollment. Enrolled patients had a point-of-care echocardiogram performed and interpreted for LV ejection fraction (EF) by a trained physician within 24 hours of their standard echo. LV EF was classified as 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, or 55%. Point-of-care echos were performed using the new Agilent``OptiGo'' cardiac ultrasound device. Each standard echo was read twice. All echocardiographic interpretations were performed blinded to one another. Agreement was defined as a difference in LV EF of 15%. Agreement rates between point-of-care echo and standard echo were determined and compared to standard echo interobserver agreement rates. RESULTS: Twenty-five physicians enrolled 510 patients. The mean age of the patients was 59.4 years and 52.8% were male. The indications for echocardiographic assessment was evaluate ejection fraction in 70.4% and evaluate murmur in 11.1%. A total of 57.9% of patients had an LV EF of > 55%, 14.2% had an LV EF of 45 ± 50%, 9.2% had an LV EF of 35 ± 40%, 7.2% had an LV EF of 25 ± 30%, and 11.5% had an LV EF of < 15 ± 20%. Rates of agreement for evaluation of LV function are shown in the table. CONCLUSION: Physicians without prior echo experience can be trained in 3-hours to assess LV function with a novel point-of-care echo device. Agreement between point-of-care echo and standard echo is similar to standard echo interobserver agreement. Wider availability of pointof-care echocardiography could improve medical care. CONCLUSION: Although only a minority of low income women report low levels of trust in their personal health care provider, lack of trust is strongly associated with lack of adherence to recommended cancer screening. Mistrust of health care providers in general and beliefs about unethical medical research practices are more common, but have less effect on use of preventive health services. Increasing trust of primary care physicians among low income populations may offer a novel approach to addressing socioeconomic health disparities.