Abstract

The "relationships between teacher, student, and patient in a changing clinical milieu" will be examined in terms of social roles and associated understandings. By social roles, I mean the various functions that the teacher or student or patient fills; and by understandings, I refer to the obligations and particularly the contracts that exist between the persons filling these roles. To set a framework, I cite the following series of assumptions: Much of what is important in the clinical training of medical students takes place in the personal transactions between the patient, the student physician, and the responsible physician. The character of these transactions is determined largely by the clinical milieu in which they occur. The milieu I refer to is not solely or even primarily the immediate physical surroundings, but rather the understandings that support the roles and associated transactions and that pervade the relationships that make up

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