Medical Education - Page 8
Georgetown, Harvard, Tufts, University of
California in San Francisco, and the
Universities of Arizona, Louisville, and
Virginia. Among the reasons offered for doing
so is that nontraditional medicine can benefit
patients, especially those suffering from
chronic pain. Physicians may sometimes find
using a holistic approach more stimulating
than merely treating diseases.
The momentum behind the drive for alternatives
to conventional medicine may
have its roots in the longstanding undercurrent
of unorthodox practices existing in medi-
cine. The assertive spirit of social movements
in our society, where the call is to take
hold of one's destiny, has probably also
impacted on the practice of medicine.
Within the medical community, there is strong
opposition by some to alternative
medical approaches, with the argument that
their claims are not subject to rigorous sci-
entific testing. Thus, physicians who desire to
include alternative therapies in their prac-
tice run the risk of ostracism. However,
intense public interest in alternative medicine is
gradually forcing a change. In mid-1992, the
National Institutes of Health opened an
office for the study of unconventional medical
practices, which will provide research
grants. Establishing good clinical trials to
test unorthodox treatments is not easy. When
definitive positive results emerge, the
possibility of including some alternative medical
practice into the mainstream of allopathic
medicine will become more likely. (For defin-
itions of alternative medical practices, see
Appendix E.)
In view of the large number of individuals
using alternative modalities, it is desir-
able that future physicians be aware of the
nontraditional practitioners and be sympa-
thetic to patients who have sought help outside
of conventional medicine.
Elective Programs
Almost all schools now offer opportunities for
students to pursue such activities as inde-
pendent study, honors programs, and special
research projects, either at home or else-
where during the academic year or in the
summer.
Elective time may be offered any year but, it
is especially common in the fourth year.
In most schools the students have the option of
consulting a faculty advisor when select-
ing electives. The extent of elective time may
vary from a number of weeks to the entire
fourth academic year. The choice of electives
will depend on a student's personal inter-
ests and talents. Clinical electives may
include additional clerkships in primary care and
in many specialties and subspecialties.
Electives may, at the medical school's discretion,
be taken at academic centers or nonacademic
centers away from one's institution of
matriculation. Thus, some choose to become
involved in a research project, while others
may select a preceptorship, practicing with a
physician in a rural community. Some stu-
dents even decide to go overseas for a period
of service (see below). In addition to clini-
cal electives, the option may exist for
electives in the basic of behavioral sciences.
Overseas Study
In the pre-World War II decades, it was common
for U.S. physicians to travel overseas,
usually to Europe, for specialty training. With
the dramatic advances in U.S. medical
education, this is no longer necessary. During
the 1980s, however, it was noted that
there was an increase in the number of U.S.
medical students taking clinical electives
abroad, especially in developing countries. It
is thought that currently more than 15% of
medical students participate in international
health projects.
Overseas study is essentially a
student-motivated undertaking. Finding an appropri-
ate place abroad that has adequate funding can
be quite difficult. The initiative to secure
a position rests with students, although they
may find a sympathetic faculty member to
assist them.
The desire to have a unique life adventure
while also serving as a goodwill ambassador
is one of the motivating factors for overseas
work-study endeavors. A more pragmatic
motive is the desire by some students to
determine which area of international health they
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