LOCKHART B. MCGUIRE, M.D.
Increased activity of medical schools in the direct provision of medical services is being advocated, both for the purpose of better distribution of expert medical care and for more balanced medical education. Such a trend could either intensify or ameliorate existing differences between academic and non-academic physicians. Characteristics of the educational setting that may complicate medical care include the varied levels of personnel involved, an emphasis on general scientific insights as well as providing of individual patient care, and often relatively aggressive diagnostic and therapeutic attitudes. Characteristics of practicing physicians include a relative emphasis on the emotional and material satisfactions of medical practice, sometimes at the expense of scientific competence and intellectual stimulation, and defensiveness about previous modes of organizing and financing medical care. Each group should review its strengths and liabilities in search of rapport.
Medical education is undergoing a major reassessment of its purposes and methods. After the Flexner report both educators and the practicing profession chose to maintain high standards of both basic scientific education and clinical training. The need for students at all levels to experience both the practice of medicine in the community as well as in the academic center and to move freely from one to the other is now coming into focus. Both the requirements of medical education and the hope of improved distribution of medical care to the public indicate a need for more active, continuing collaboration between "gown" and "town" than has recently prevailed.
MCGUIRE LB. Curriculum Changes: Pass or Fail for Town and Gown. Ann Intern Med. ;68:934–945. doi: 10.7326/0003-4819-68-4-934
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Published: Ann Intern Med. 1968;68(4):934-945.
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