I have written about medical education on numerous occasions over the last 7 or 8 years. It’s an important subject that has undergone changes, about which I have opinions, and has altered its focus and emphasizes more than mere rote memorization. Medical education was the responsibility of specialty physicians who imparted upon students every bit of knowledge possible in their field. This provided a well-rounded educational experience, but it fostered a tendency among students, to select a single area of interest that became your specialty.
Primary care was an area of medicine that was not emphasized by educators and was chosen because students wanted to pursue that from the beginning, or some major influence, or the lack of interest in one narrow field, pushed them to select family medicine. Medical education still remains heavily specialty oriented, but 47 osteopathic colleges of medicine and 22 new osteopathic teaching campuses have gone a long way toward narrowing the primary care-specialist physician gap.
A few influential medical educators have advocated vigorously for primary care and made in-roads, but surgeons and medical sub specialists have had all the clout for shaping medical education and exert a strong specialty orientation. But some things finally are changing.
Some schools tailor their educational emphasis to better serve the community in which they are located. Kaiser Permanente students are required to spend a half day a week with a preceptor in a federally qualified health center learning the needs of the medically underserved population. Some schools have started teaching history taking and generalized physical assessment from day one, rather than waiting until the second semester of year two. This begins to sharpen a students history and physical abilities early on. Plus it makes the student feel like he/she is actually learning skills they wanted to learn to be a physician and are not spending all their time learning basic science information they may rarely use when in practice.
Some schools are involving students in research projects that are really community service oriented programs. They learn how to deal with the factors that make their community what it is, and train them for long-term service to the community. They dedicate one day a week to working on their project which has a practical purpose and is not just an exercise.
Also emphasized are “household level factors” such as “housing, food security, transportation, and employment,” factors that directly and indirectly influence health. Much greater emphasis is placed on the socioeconomic factors involved with illness rather than rattling off a list of differential diagnoses.
New emphasis is placed on communication and being a good citizen along with being a good doctor. Both go hand-In-hand. Early patient contact improves students’ comfort and experience in dealing with the variety of personality quirks humans possess.
With a projected shortage of 86,000 physicians in 10 years, it behoves medical educators to expedite the training process and produce more practitioners who are academically and socially sound.
Reference: How New US Medical Schools are Training Clinicians. medscape.com 2026 October 8.
