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The future for medical education
http://www.100md.com 《英国医学杂志》 2005年第7期
     1 University of Lisbon, Santa Maria Hospital, 1649-035, Lisbon, Portugal

    One of the most frustrating things for medical students is knowing what is wrong with their medical education but not being able to do much about it. Medical school is already gruelling and time consuming enough, and in those rare moments when we stop to catch our breath and think a bit about life, we realise that no matter how much our education makes us yawn, or of how the school is serving the interests of its educators rather than those of its students, things won't change from night to day. Thus we sigh and hope that the following generations of students will be more fortunate.
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    However, the advent of the internet, the information society, and the increasing number of possibilities to study and train abroad have made it easier than ever before to try to make up for the flaws and shortcomings of our medical education. Some people even succeed in moving overseas to study or work in systems that they view as providing better education.

    A brighter future

    The International Campaign to Revitalise Academic Medicine scenarios offer a lot of fresh and exciting insights into how academic medicine should evolve in order to better serve the needs of students.1 Take, for instance, the scenario of Reformation in which medical students first learn how to learn and then learn by doing. One of the most pressing issues in medical education is to make it as practical and hands-on as possible. Medical students don't care about learning for learning's sake; they want to learn the knowledge and skills that will truly matter to them in their career.
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    This scenario also highlighted the issue of multidisciplinary work. Medical students are not formally taught to relate to or work with other healthcare professionals. Although multidisciplinary work is far from being a major concern on the agenda, it will become increasingly important in the future. Perhaps as a sign of the changing times, medical students can look forward to the first world medical and pharmacy students' joint symposium later this year.2

    In the United States, medical training is already trying to cater for students' differing needs and motivations, and taking into consideration the importance of interfacing with other areas of knowledge. Universities offer combined programmes such as MD/MBA (business), MD/JD (law), or MD/PhD.3 I hope evolution will not halt here and that what we have now is simply the embryonic stage of what in the future may become the effective "niche training" envisioned in Academic Inc.1
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    Each country or medical system (be it at government or medical students' association level) can draw plenty of inspiration from these scenarios when planning an overhaul of academic medicine. The magic formula to raise academic medicine from its hospital bed is likely to consist of a mix of the ingredients from all the scenarios. The magic lies in knowing which proportions of each of these ingredients work best.

    Competing interests: None declared.
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    References

    Clark J. International Campaign to Revitalise Academic Medicine. Five futures for academic medicine: the ICRAM scenarios. BMJ 2005;331: 101-4.

    Spry E. Medics worldwide: news and opportunities from the IFMSA. studentBMJ 2005;13: 181.

    Hwang R. Becoming a US medical doctor. studentBMJ 2005;13: 239-40., http://www.100md.com(Tiago Villanueva)