Campaign to revitalise academic medicine
http://www.100md.com
《英国医生杂志》
EDITOR—Fundamental revision of academic medicine1 might start by considering:
Expanding medicine's biomedical world-view to include the impacts of social, emotional, environmental, familial, and occupational factors on health and disease
Expanding major educational venues beyond the hospital to doctors' offices, patients' homes, nursing homes, rehabilitation units, and hospices
Replacing the emphasis on single "causes" for most diseases with profiles of predisposing, precipitating, and perpetuating factors that recognise clusters or sequences of the several elements required to evoke biological or behavioural changes—for example, genes, diet, and sedentary lifestyle for diabetes; strong coffee, ageing, and stress for atrial fibrillation; poverty, depression, and the tubercle bacillus for tuberculosis; climate change, stress, depression, and a virus for the common cold
Requiring graduates to be knowledgeable about current concepts, methods, contributions, and limitations of clinical, biomedical, behavioural, and population perspectives in medicine
Shrinking basic science courses and incorporating their principles in longer exposures focused on the rationales, relative efficacy, and costs for diagnostic, pharmacological, procedural, behavioural, and population interventions
Requiring students to determine hospitalisation and annual prescription charges and costs for each patient
Incorporating a short course by an aviation safety engineer on how "near misses," errors, and catastrophes are reported and managed
Incorporating lecture/reading/study/essay courses on the history of medicine and the scientific method and on works by doctors and nurses covering pain, suffering, deprivation, disability, and medical encounters
Requiring students to write two papers ("acute" and "chronic" illnesses) discussing how the illness was first labeled; the diagnostic criteria; numbers and rates for each in their city, county, state, or province, and nation; how health departments obtain this information; the efficacy and individual and collective costs of interventions; who pays; and what is being done to prevent and limit the spread and deterioration of each disease.
Kerr L White, retired deputy director for health sciences
Rockefeller Foundation, New York Charlottesville, VA 22911, USA Klw2j@virginia.edu
Competing interests: None declared.
References
Tugwell P. Campaign to revitalise academic medicine kicks off. BMJ 2004;328: 597. (13 March.)
Expanding medicine's biomedical world-view to include the impacts of social, emotional, environmental, familial, and occupational factors on health and disease
Expanding major educational venues beyond the hospital to doctors' offices, patients' homes, nursing homes, rehabilitation units, and hospices
Replacing the emphasis on single "causes" for most diseases with profiles of predisposing, precipitating, and perpetuating factors that recognise clusters or sequences of the several elements required to evoke biological or behavioural changes—for example, genes, diet, and sedentary lifestyle for diabetes; strong coffee, ageing, and stress for atrial fibrillation; poverty, depression, and the tubercle bacillus for tuberculosis; climate change, stress, depression, and a virus for the common cold
Requiring graduates to be knowledgeable about current concepts, methods, contributions, and limitations of clinical, biomedical, behavioural, and population perspectives in medicine
Shrinking basic science courses and incorporating their principles in longer exposures focused on the rationales, relative efficacy, and costs for diagnostic, pharmacological, procedural, behavioural, and population interventions
Requiring students to determine hospitalisation and annual prescription charges and costs for each patient
Incorporating a short course by an aviation safety engineer on how "near misses," errors, and catastrophes are reported and managed
Incorporating lecture/reading/study/essay courses on the history of medicine and the scientific method and on works by doctors and nurses covering pain, suffering, deprivation, disability, and medical encounters
Requiring students to write two papers ("acute" and "chronic" illnesses) discussing how the illness was first labeled; the diagnostic criteria; numbers and rates for each in their city, county, state, or province, and nation; how health departments obtain this information; the efficacy and individual and collective costs of interventions; who pays; and what is being done to prevent and limit the spread and deterioration of each disease.
Kerr L White, retired deputy director for health sciences
Rockefeller Foundation, New York Charlottesville, VA 22911, USA Klw2j@virginia.edu
Competing interests: None declared.
References
Tugwell P. Campaign to revitalise academic medicine kicks off. BMJ 2004;328: 597. (13 March.)