Defining medical basic science: general internists' special role in the reformation of medical school education.

Abstract

As general internists we have a special role to play in the current efforts to reform how basic sciences are incorporated into medical education. The articles by Brass1 and Fincher and colleagues2 highlight the major points of view in the current debate over how best to restructure medical education to incorporate an ever-expanding scientific knowledge base and better prepare future physicians to practice in a rapidly changing health care delivery landscape. Brass takes the provocative view that the focus on basic sciences in medical education has become fuzzy, to the detriment of medical education and the recruitment of internists and physician scientists; he fears that the proposed changes to the structure of the pre-clinical curriculum threatens the quality of medical education, the physicians it trains, and the future of internal medicine. He warns that if not addressed, this trend away from formal teaching of basic science will make the field of internal medicine less attractive to medical graduates. Fincher and colleagues agree with the premise that basic sciences are important to the training of physicians, but that given the complexity of medical knowledge and practice, call on us to reconsider what constitutes these foundational medical sciences and ensure that we teach them as they will be practiced, in the context of clinical problem solving. We agree with both and argue that as general internists we are in the unique position to define and advocate for best basic medical science educational practices as the foundation for excellent medical practice.