Ten things I learned when writing a book of medical education quotations
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Ten things I learned when writing a book of medical education quotations Kieran Walsh
Received: 10 December 2012 / Accepted: 7 January 2013 / Published online: 22 January 2013 Ó Springer Science+Business Media Dordrecht 2013
Abstract Medical education has had a long history. Much of that history can be captured in quotations from the many people who have made medical education what it is today. Even though newcomers to the field often see and approach problems as if they were the first to discover them, examining quotations makes us realise that ideas of reform in medical education have been around a long time. Despite the longevity of ideas however, the pace of change has sometimes been slow. Quotations can help us realise the myriad of reasons that have contributed to this slow pace—sometimes a fear of change, sometimes an ill-conceived desire to develop innovations that will be proved to work for all learners in all circumstances. Even though quotations can show where medical education in the past has at times gone wrong, they can also point to a bright future—where intelligent and passionate people reflect and debate on the directions that our important specialty should take. Keywords
Medical education Quotations Cost Evidence Change
Our current generation didn’t invent medical education reform When I first became interested in medical education, I came to the subject with the zeal of the reformer. I thought about what was wrong about my undergraduate education, the examinations I had sat, and the postgraduate training that I had received. We are going to do much better by the next generation I thought, and the first step in reform will be rationalising the curriculum. It always comes as a shock to the reformer that someone has been there before them. Here is Thomas Lewis on curriculum overload: ‘‘In considering the usual medical curriculum of to-day, and asking where in it clinical science is to play its part, I would start from the statement that this curriculum is already overloaded’’ (Lewis 1935). The General Medical Council in the UK first started to take curriculum overload seriously in the 1990s, so you would be forgiven for thinking that the quote comes from K. Walsh (&) BMJ Learning, BMJ Group, BMA House, Tavistock Square, London WC1H 9JR, UK e-mail: [email protected]
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that decade and not 60 years before. Robert Barnes was writing about the same problem in the mid-Victorian era: ‘‘Time may be gained by the simple and common-sense process of striking out of the curriculum teaching that oppresses and bewilders the student, that distracts his attention from the real object of his study, that loads his memory without training his intellect’’ (Barnes 1875). Did ideas of reform in medical education start then? In an early plea for better co-ordination of care and perhaps more interprofessional education, Alexander the Great cried out from his deathbed, ‘‘I am dying with the help of too many physicians’’ (Alexander the Great 323BC). And 100 years before that, Hippocrates was
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