Education--the concern of the profession? Undergraduate medical education

In this brief review not all aspects could be covered. The main requirements for improvement are: Reorganise the Medical Council - expand the role of its educational committee and establish a curriculum advisory body. Begin a continuous evaluation process of medical education. Colleges and medical associations begin debating their role, involving lay organisations in the process. Curriculum committees and medical schools look at four areas of criticism (begin planning introduction of early clinical contact, problem solving, critical approach, self learning) and contemplate reduction in length of course. The direction of medical education following Flexner was the centres of medical excellence, these became the teaching hospitals and they have become the trap leading to a distorted view of medicine. That they have produced many advances is not disputed. That they will continue to do so is to be expected, although they are now retarding progress in the important and neglected areas that hold the most potential for benefit--prevention and primary care. The new direction of excellence must not be solely into institutions, but must now be into the minds of all the individual members of the profession. The institutions will change, as society does, along with increasing knowledge, but if possession of the habits of continual critical inquiry is equally represented in all members of the profession, then they will adapt more quickly and appropriately to the requirements in the future.     

Education--the concern of the profession? Early postgraduate medical education

Overall what is suggested is a tried and proven apprentice type system, with continuing role models, more stable patient care teams, defined educational objectives, all with some flexibility and a reduction in the tendency to over supply in specific areas. The transition would be difficult, it could not happen without change (already suggested) in the undergraduate curriculum and it would also require changes in other areas, peripheral to the areas of hospital organisation already discussed. The changes necessary for the full effect of these proposals to be felt, will be those occurring in medical society. The changes will be in the methods of practice, in organisation and payment and in the relationship of different parts of the profession (aiming for abolition of the dichotomy existing between primary care and the hospital), all sections taking an active part in planning and delivering medical education. A clear commitment must be made to continually evaluate medical education's performance and relevancy, connecting this to institutions (medical schools, hospitals, colleges etc) geared and prepared to respond. A reconstituted and reorientated Medical Council would be pivotal to this being successful. This two year spell inflicted on the young members just entering our profession is inexcusable in humanitarian terms, wasteful in educational terms, and ineffective in management terms.     

The medical profession and changing attitudes towards advertising and competition

This paper examines the attitudes of general medical practitioners towards competition and advertising and the changes that have occurred between 1985 and 1988. The data was derived from a self completion questionnaire, 1500 of which were evenly distributed among the members of five professions; doctors, dentists, lawyers, accountants and veterinarians. General practitioners are now favourably disposed towards advertising by the profession as a whole in an effort to increase awareness of medical services (70% in favour in 1988 compared to only 53% in 1985), but the perceived need for increased business efficiency has lessened (70% in 1988 compared to 78% in 1985). Collegiality continues to be the dominant ideology but this position has weakened slightly. In 1988 only 65% of general practitioners regarded other members of the profession as colleagues rather than competitors, compared to 73% in 1985.