Clinical education: context is everything

摘要

There are times I wish I was a cartoonist and this is among them. How else can we easily portray the mad dash of medicine into the sub-specialty stratosphere? This trend leaves behind too few to sort out the messy collision between the human experience of illness and the complexity of modern medical care that occurs where we mostly live - in the community. The debates I see in medical schools, at the operational level, are often not about what sort of doctors our societies will need in the next decade or so and how we will achieve them. Rather, the focus is on the problem of having insufficient curriculum time to represent the fullness of an emerging sub-specialty and how and where to fit it into the existing curriculum. On top of this, generalism as an end-point is often demeaned. The result is a situation in which we do not have enough doctors with the right skills in the right places, accompanied by an alarming lack of interest amongst students in following generalist careers.1