Woollard Robert F
Department of Family Practice, University of British Columbia, Canada.
Med Educ. 2006 Apr;40(4):301-13. doi: 10.1111/j.1365-2929.2006.02416.x.
The concept of 'the social accountability of medical schools' is moving from the peripheral preoccupation of a few to a more central concern of medical schools themselves. Born of concerns about the professionalism and relevance of both the institutions and their graduates, it is seen increasingly as an urgent call to focus the considerable social resources vested in academic health science institutions on addressing the priority health concerns of the societies they serve. For a profession embedded in an ethos of service, this would seem an obvious transition. However, as with any movement towards transformative change, it runs the risk of being more mantra and rhetoric than mandate and responsibility. NEEDED RESPONSE: Proceeding from the assumption that good intentions alone are not enough, this paper seeks to outline the historical development and some current expression of the concept throughout the world. The sadly divergent wealth and health status of modern societies calls for very different actions by medical schools across the spectrum from the least endowed to the wealthiest of schools. In a profession claiming centuries of cohesive commitment to the welfare of others, it is increasingly urgent that the current generation of medical educators converge on a relevant set of principles and coherent activities. TOOLS FOR THE TASK: While recognising that they are closely intertwined, the paper outlines the difference between the social accountability of the institutions themselves and the social accountability of the graduates they produce. It outlines both individual examples and the international initiatives that are fostering and facilitating institutional collaborations to bring both progress and optimism to this daunting task. It provides connections to practical resources for those who are committed to that task. Other papers in this series add further practical insights into the central role that medical educators must play if we are to fulfil the responsibilities we carry with the privilege of our profession.
“医学院校的社会问责制”这一概念正从少数人的边缘关注,转变为医学院校自身更为核心的关切。它源于对医学院校及其毕业生的专业性和相关性的担忧,如今越来越被视为一种紧迫的呼吁,即要将投入学术健康科学机构的大量社会资源,集中用于解决它们所服务社会的优先健康问题。对于一个秉持服务精神的职业而言,这似乎是一个显而易见的转变。然而,与任何朝着变革性变化的运动一样,它存在沦为口号和言辞而非使命与责任的风险。
本文基于仅有良好意愿是不够的这一假设展开,旨在概述该概念在全球的历史发展及一些当前表现形式。现代社会令人遗憾的财富与健康状况差异巨大,这要求从资源最匮乏到最富裕的各类医学院校采取截然不同的行动。在一个宣称对他人福祉有着数百年凝聚性承诺的职业中,当务之急是当代医学教育工作者就一套相关原则和连贯活动达成共识。
尽管认识到机构自身的社会问责制与它们培养的毕业生的社会问责制紧密相连,但本文仍概述了两者之间的差异。它列举了个别事例以及促进机构合作的国际倡议,这些合作给这项艰巨任务带来了进展与希望。它为致力于此项任务的人提供了与实际资源的链接。本系列的其他论文进一步深入探讨了,如果我们要履行因职业特权而肩负的责任,医学教育工作者必须发挥的核心作用所具有的实际意义。