Curriculum Innovations and Alternative Models of Medical Education

Since the 1950s, newly established medical schools have adopted novel curricular designs such as the organ-system model (Case Western) and the Flexible (elective) model (Duke University School of Medicine). The traditional knowledge-oriented programs were replaced with mission-oriented curricula emphasizing skill acquisition. Although committed to problem-solving rather than knowledge, most innovative curricula have invested efforts to improve learning efficiency, and rigid teaching programs were replaced with programs matched to individual students by allowing each of them to learn at his/her pace. This section describes four curricular innovations: the problem-based, self-directed learning model, the early exposure of students to patients, the integrated longitudinal clerkship model in primary care clinics, and the shift to accepting uncertainty in clinical practice.