Medical education

Article Abstract:

The 1974 to 1988 trend of diminishing medical school applications appears to be changing, with 1989 applicants numbering 0.7 percent more than those of the previous year. The medical profession is apparently looking more attractive to young people. A major change is scheduled to take place in the Medical College Admission Test in 1991, enabling medical schools to select students on the basis of their abilities for critical thinking, logical reasoning, problem solving, and other areas besides scientific knowledge. The examination will even contain an essay. Minority enrollment in medical schools continues to be low and this situation is being addressed through early intervention programs. Financial aid programs for medical students need to be expanded; 81 percent of all graduates are in debt. The course of study in medical schools is shifting from lectures toward tutorials and small group sessions. Problem-based and case-based learning methods are gaining acceptance. Clinical education now takes place in a variety of settings outside of the teaching hospital, since medicine is now practiced in a variety of situations. One proposal for reform is to merge the fourth year of medical school with the first year of postgraduate training, thereby shortening the overall training period to six years. At that time, the student would be certified as a primary care physician. More primary care physicians are needed, as students' interest in this specialty wanes. If teaching in the ambulatory setting becomes more widespread, major curriculum revision will be in order, as well. The kinds of broad-based knowledge necessary for practicing general medicine in this setting are discussed. Medical informatics should be included in the list of reforms for medical school curricula, as should case management skills. Medical education needs to improve to justify the resurgence of interest young people currently express. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Reports, Demographic aspects, Appointments, resignations and dismissals, Medical education policy, Medical college applicants, Medical school applicants

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Physician, educate thyself

Article Abstract:

Medical education must include health policy issues and medical institutions must value physicians with expertise in this subject. Many medical students and residents are unable to participate in health care reform discussions because they lack knowledge of health policy. Students may not educate themselves about this topic because they are focused on a narrow range of interests. They prepared themselves for medical school with in-depth study of basic science. As resident physicians, they strive for clinical competence and subspecialty training. The broader social issues in medicine are ignored. Faculty who are the products of this educational system are ill-prepared to promote change. This gap in medical education relegates physicians to roles as observers rather than participants in health care reform. Medical schools should admit students with a primary interest in health policy and must cultivate this interest among all students.

Study and teaching, Medical policy, Health policy

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Defining the good doctor

Article Abstract:

The multiple choice tests used to rate physicians for board certification and re-certification cannot evaluate clinical skills like problem management and qualities like compassion and integrity. Researchers asked professional associates such as fellow physicians and nurses to rate physicians' clinical performance, communication skills and humanistic qualities. Reliable ratings were obtained when at least 11 professional associates filled out the questionnaire. Before a system of peer ratings can be widely used for physician evaluation however, some questions must be answered: will the medical community accept this system? Will these ratings be used for legal purposes like malpractice suits? How will all the paperwork be organized? How reasonable is the cost of implementing such a system?

Editorial, Analysis, Evaluation, Physicians, Medical professions, Peer review

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