Today's agenda: Transforming curricula in a new era of collaborative patient-centred approaches to healthcare delivery

摘要

At every turn medical schools are revising or as many state transforming their curriculum.1 There is always a need to reflect on how we train doctors especially in the light of scientific progress within global health priorities. As we move swiftly into the 21st Century we continue to see changes because of the advancement of medical science such as people with complex co-morbidities living longer and disabled patients enabled to live independently. Surgical procedures are less invasive, some carried out with the use of new technologies such as robots, with surgeons concentrating on interventions to speed up or enhance recovery. Financing and managing health and social care remain core concerns. Recent falls in global economies have placed difficult ethical funding challenges on the shoulders of clinical leaders at a time of increasing public demand. Some of these challenges relate to how doctors can reduce costs by minimising unnecessary clinical interventions, through vigilance to protect resources and on cutting down on waste.2, 3 Today's patients are less tolerant and often present after consulting the fountain of knowledge within the World Wide Web. Some seek legal advice following negative outcomes leaving many doctors demolished and demotivated. Many others demand accessible local services for regular health checks and expect direct rapid access to rectify their problems. Globally there are shortages of doctors, especially in the underdeveloped countries and we ignore inequalities in health at our peril, consider, for example, the lack of early response to the Ebola virus. Even within advanced economies such as the UK, 60–90% of hospital admissions come from those who live in areas of socio-economic disadvantage, which for the Western economies relate to obesity, diabetes, addiction and mental health concerns.4, 5 So what do these changes mean for medical educators? Obviously as a starting point, each of these new developments must be in any revised curriculum alongside the existing requirements of science and practice with the ever long-term goal of making safe, competent, professional and committed doctors. On the same note, acedemic expertise, qualifications, and increasing workloads should also be considered while embedding new domains in the existing curricula or while importing a brand new curriculum to the medical schools.