We hope that this may contribute to the often contentious discourse on the best method(s) for educating and guiding medical students into the ever-changing world of medical practice, where they will be confronted by at least 2 evolving challenges: (1) an increasingly commercialized, bureaucratized, and impersonal health service structure and (2) patients with perennial fears, hopes, and expectations. The purpose of this article is to draw on our combined experiences to critically reflect on undergraduate medical education (UME). Over the past half century, we have been immersed in teaching, evaluating, and observing medical students’ maturation into competent, caring physicians. Finally, more appropriate funding of medical education would alleviate some of the burden and anxiety by acknowledging its nonmaterial value. Third, some discussion about medical education pedagogy and curricular development ought to have a place in UME to prepare the next generation of physicians for ongoing changes in accreditation and in approaches to education. Second would be a more gradual introduction of the proposed changes. First, a more condensed approach to faculty development may be to ensure that bringing teachers up to speed on the new curriculum is not excessively burdensome.
To address challenges stemming from pedagogical changes, the authors offer 4 observations.
The authors highlight the role of generalism as an essential foundation of UME, as well as the dilemma of a shrinking cadre of medical students choosing a generalist career path. Specifically, these tensions arise from the differing trajectories and directions of the 3 traditional pillars of academic medicine: clinical excellence, state-of-the-art education, and cutting-edge research. They briefly review curricular changes in medical education over the past 100 years, then focus on the dynamic tension in undergraduate medical education (UME) resulting from new pedagogy. The authors draw on their many decades of combined experience with medical students, observing their maturation into practice in widely differing contexts, to reaffirm some of the essential goals of medical education.
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