Medical education today: all that glitters is not gold

L Maximilian Buja

doi:10.1186/s12909-019-1535-9

Abstract

BackgroundThe medical education system based on principles advocated by Flexner and Osler has produced generations of scientifically grounded and clinically skilled physicians whose collective experiences and contributions have served medicine and patients well. Yet sweeping changes launched around the turn of the millennium have constituted a revolution in medical education. In this article, a critique is presented of the new undergraduate medical education (UME) curricula in relationship to graduate medical education (GME) and clinical practice.DiscussionMedical education has changed and will continue to change in response to scientific advances and societal needs. However, enthusiasm for reform needs to be tempered by a more measured approach to avoid unintended consequences. Movement from novice to master in medicine cannot be rushed. An argument is made for a shoring up of biomedical science in revised curricula with the beneficiaries being nascent practitioners, developing physician-scientists --and the public.ConclusionUnless there is further modification, the new integrated curricula are at risk of produce graduates deficient in the characteristics that have set physicians apart from other healthcare professionals, namely high-level clinical expertise based on a deep grounding in biomedical science and understanding of the pathologic basis of disease. The challenges for education of the best possible physicians are great but the benefits to medicine and society are enormous.

Highlights

The medical education system based on principles advocated by Flexner and Osler has produced generations of scientifically grounded and clinically skilled physicians whose collective experiences and contributions have served medicine and patients well
Unless there is further modification, the new integrated curricula are at risk of produce graduates deficient in the characteristics that have set physicians apart from other healthcare professionals, namely high-level clinical expertise based on a deep grounding in biomedical science and understanding of the pathologic basis of disease
Sweeping changes launched around the turn of the millennium have constituted a revolution in undergraduate medical education (UME) and graduate medical education (GME) [1,2,3]

Summary

Discussion

Reform movement and integrated curriculum To promote more active learning and less passive learning, curriculum developers have introduced a variety of approaches, including small group sessions, problem-based learning, self-directed learning, team-based learning, and flipped classrooms as replacements for the traditional lecture format [21]. Since a solid understanding of pathology is core to the practice of medicine in any specialty, the position paper posits that all medical students must learn the basic mechanisms of disease, their manifestations in major organ systems, and how to apply that knowledge to clinical practice for diagnosis and management of patients. These advocates say that solutions require creativity and action from residency selection committees and the USMLE’s sponsors, the Federation of State Medical Boards and the National Board of Medical Examiners, because of the implementation of the new UME curriculum Those in control of the UME curriculum can ensure that meaningful objective summative assessments of students in both pre-clinical and clinical courses are included in dean’s letters so that the USMLE is not the sole or primary objective assessment presented to residency selection committees. The combination of educational deficiencies coupled with lifestyle preferences carries the risk of diminishing the status of future physicians [33]

Conclusion

Background

Findings