Perspectives in biology and medicine
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The Flexner Report established guidelines for medical education and made the university the obligate home for medical education. Flexner mandated specific elements necessary for university-based premedical education. With the exception of the MCAT, much less attention has been paid to premedical education and its integration into the scope of medical education than to education within the confines of the medical school. This article reviews the history of premedical education, describes some recent critiques of premedical education, discusses a newer program for premedical education evolving at the University of Illinois at Chicago, and offers some suggestions for the future.
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Perspect. Biol. Med. · Jan 2011
Historical ArticleThe rise of fibromyalgia in 20th-century America.
At the beginning of the 21st century, fibromyalgia syndrome (FM) has become a diagnostic category that includes extremely large numbers of people, predominantly women. Yet only a few decades ago, FM (and its predecessor fibrositis) was of little interest or concern to either physicians or the general public. ⋯ Broad social and intellectual currents, internal developments within medicine, the appearance of a self-conscious women's movement, and the rise of an increasingly important pharmaceutical industry all converged to elevate the importance of FM. Yet the diagnosis has remained highly contested, and there are competing etiological theories and therapies.
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Medical educators are facing a challenge today that is quite analogous to that addressed by Abraham Flexner, namely how to transform a legacy system of education that is no longer preparing future physicians adequately to meet contemporary expectations and responsibilities. In facing up this challenge, however, today's educators not only must equip students to deal effectively with the rapidly changing paradigms in health care and medical practice, they also must adapt their curricula and pedagogical methods to the demanding new paradigms of medical education. Their success in addressing these dual imperatives will determine whether the educational transformations currently underway will have as momentous an effect on the public's health as did those stimulated by Flexner a century ago.
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Perspect. Biol. Med. · Jan 2011
Evolution of the New Pathway curriculum at Harvard Medical School: the new integrated curriculum.
In 1985, Harvard Medical School adopted a "New Pathway" curriculum, based on active, adult learning through problem-based, faculty-facilitated small-group tutorials designed to promote lifelong skills of self-directed learning. Despite the successful integration of clinically relevant material in basic science courses, the New Pathway goals were confined primarily to the preclinical years. ⋯ In 2006, Harvard Medical School adopted a more integrated curriculum based on four principles that emerged after half a decade of self-reflection and planning: (1) integrate the teaching of basic/population science and clinical medicine throughout the entire student experience; (2) reestablish meaningful and intensive faculty-student interactions and reengage the faculty; (3) develop a new model of clinical education that offers longitudinal continuity of patient experience, cross-disciplinary curriculum, faculty mentoring, and student evaluation; and (4) provide opportunities for all students to pursue an in-depth, faculty-mentored scholarly project. These principles of our New Integrated Curriculum reflect our vision for a curriculum that fosters a partnership between students and faculty in the pursuit of scholarship and leadership.
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Medical education in the 20th century has been vastly influenced by the Carnegie Foundation Flexner Report. The basic tenets of the modern four-year medical curriculum and the dominant role of the associated university teaching hospital were cemented into place and have remained the paradigm of the present-day medical educational process. ⋯ Despite enormous success, a number of current problems have been identified in today's medical educational curricula and have catalyzed the generation of a new Carnegie Foundation report that emphasizes the building of strong bridges across the artificial divide that separates the basic science and clinical years and lays the foundation for the growth and development of translational medicine. In addition, the report raises crucial issues regarding a national medical workforce policy.