When evidence is lacking, decisions are usually made on the basis of common sense and experience. When I started teaching clinical epidemiology in 1989, there was no thing such as evidence-based medicine (EBM) and tomorrow's doctors had yet to appear. Public health medicine was an extremely marginalized discipline with a low profile, both within the medical profession and the broader public arena. Things have changed. Now even my most skeptical clinical colleagues begrudgingly accept that a medical student in the twenty-first century must be proficient in the critical appraisal of evidence, understand concepts such as the numbers needed to treat (assuming they know what that is!) and have some understanding about global threats to health from climate change to pandemics. Public health educators have often been pushing on an open door. Despite this newly won respect, educational tensions, some old and some new, persist and have been usefully highlighted by Gillam and Maudsley. I have focused on some of what I feel are key topics and what follows is purely 'opinion-based'.
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