P R Health Sci J
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The 21st century brings new challenges to academic medical centers and universities who are responsible to prepare health professionals. These academics medical centers and universities need to respond more effectively to the demands of the health market place. The Health Care reform has brought about many changes within the health care field. ⋯ Advance practice nurses and paramedics will take over some of physicians' duties such as diagnose and prescription of medications and treatment to the patients. For individuals to move vertically to positions and to be marketable in health care settings, they need to increased their personal and technical skills, and health care knowledge. In order to survive, the health care professional will need to gain increased competencies and skills in several areas rather than obtain proficiency in one specific area.