Issues that May Require Curricular Changes

Experts agree that there is a gap between how physicians are trained and the needs of the healthcare system. Already today, the traditional focus on knowledge is being expanded to include competence and the ability to deal with unfamiliar clinical problems. Undergraduate medical curricula are redesigned to include decision theory, information access, and critical interpretation of evidence. Realizing that hospitals no longer provide an appropriate learning environment has led to allocating clinical clerkships to primary, consultant, and perinatal outpatient clinics. This section addresses topics that may require additional curricular changes. Medical schools may wish to reconsider their selection of applicants, attempt to shorten the duration of medical education, and promote student well-being. Second, they should develop methods to teach students social and behavioral sciences, clinical reasoning, effective teamwork and avoidance of unprofessional behavior, and how to handle time-limited doctor-patient encounters. Third, review the appropriateness of the clinical learning environment in hospitals that allow private treatment in countries with universal health insurance. Finally, consider combining the final evaluation of medical school graduates with counseling regarding their future careers.