Abstract
Postgraduate education in medicine is flawed because medical education itself is flawed. The basic premises and tools for medical education and practice must be changed. Until these changes are made, the medical care system will continue to fail to consistently couple for each patient the best current thinking in an area to the everyday actions in that area. Audits of medical practice, criticism of physicians, public discussion of bad outputs of medical practice, and malpractice suits will not help because awareness of the problems is not the difficulty. The difficulty is the failure to act upon the awareness in realistic and constructive ways. The PROMIS system is based on new premises and new tools that are effective and constructive.
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