Partnerships in Medical Education

The following discussion is intended as a reminder of critical issues that have attracted the interest of the medical education community during the past year.

Abstract

We frequently hear that the United States has one of the best—if notthebest—medical education systems in the world. However, with the same frequency, detractors complain about the system's resistance to improvements and change. As Alvin Tarlov, MD,1recently observed, from a sociologic perspective, medical institutions may reach a level of maturity that leaves them paralyzed and unable to reform themselves. After years of experimentation and discussion, modifications are just now being made to a stable and entrenched medical education establishment, notorious for rejecting innovation. The following discussion is intended as a reminder of critical issues that have attracted the interest of the medical education community during the past year. Some of the very factors that make the US system successful also deter change. A conglomerate of connected but relatively independent components, medical education thrives on the American traditions of decentralization and autonomy. But national efforts, such as