Physicians and Medicine in the 21st Century - Page 3
on medical education. Schools will need to be
offered the means of gaining a broad
enough experience to train students to meet the
needs of the coming century. Ideas for
reforms are under active discussion and some
have been made over the years. The
prospects are favorable for significant progress
in the foreseeable future.
While recognizing the need to develop a new type
of physician, there is a realization
that medical schools can't, on their own,
generate more primary care M.D.s. The market
forces seem now to be slowly reversing the
equation, making subspecialists less in
demand, while generalists are becoming more
attractive. As the impact of these forces
become known to medical students, their career
goals may better fall in line with
prospects for employment.
Medicine is a very dynamic profession. It
changes not only as a result of advances
in medical knowledge and technology, but also
because of changes in the way medical
care is offered. For the past number of years,
health care has been the subject of a
national debate. The reforms that will take
place in the U.S. health system will signifi-
cantly impact on all aspects of medicine
including premedical education, admission to
medical school, medical education, medical
students, health care delivery, and physi-
cians' specialties. The effect on each of these
the components will be discussed in the
rest of this chapter.
PREMEDICAL EDUCATION
The practice of medicine, as it has been
evolving over the past decade, suggests that in
the twenty-first century it will differ
significantly from medical practice in the twentieth
century. It is therefore reasonable to assume
that premedical education goals will also
need to be refocused appropriately. The basic
learning goals to be emphasized in college
are as follows:
1. Become familiar with the rapid advances in
medicine that preclude the possibil-
ity of being able to rely indefinitely on
knowledge solely gained in medical
school and postgraduate training. One should
pursue subjects of interest in
either general or specialized areas for the
sake of constantly acquiring more
knowledge.
2. Develop skills in computer technology,
especially with regard to communica-
tion skills. Accessing and sharing available
information will be essential for
making critical judgments.
ADMISSION TO MEDICAL SCHOOL
The AAMC's Council on General Professional
Education of the Physician (GPEP), after
a three-year study involving leading medical
educators issued a report whose recom-
mendations are believed to be of such import,
that they could impact very significantly
on the training of physicians for practice in
the twenty-first century. The GPEP recom-
mendations are relevant to both premedical and
medical students. For those planning a
medical career, the following recommendations
are of special interest:
1. College faculties should require that the
education of all students encompass
broad study in the natural and social sciences
and in humanities.
2. Medical schools should require only
essential courses for admission; these
should be part of the core curriculum that all
college students must take.
3. Medical school admissions committees'
practice of recommending additional
courses beyond those required for admission
should cease.
4. Medical schools should modify their
admissions requirements, so that college
students who apply and have successfully
pursued a wide range of study may be
viewed as highly as the students who have
concentrated in the sciences.
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