Changing Views on Medical Education and Training

摘要

Ash and Weinstein¹ point out that medical training has remained largely unchanged. There is a lack of evidence on how best to improve the medical workforce. Education has not been subjected to the same rigorous examination that is encountered in biomedical research. This is, perhaps, understandable. It is more difficult to quantify whether medical schools and postgraduate training programmes are doing a good job. Currently evaluations are largely based on whether the student or trainee is receiving sufficient lectures, enough clinical exposure, and her ultimate success in the assessments and examinations. None of these measures inform us on the relationship between clinical competency and better patient outcomes. These considerations are important and lead on to the question whether training should be time-based or competency-based. Currently all our training programmes are time-based although we are well aware that trainees progress and advance at different rates.