Medical education at the crossroads: which way forward?

Over the last 30 years, several changes have been introduced in medical education including the introduction of new contextualized approaches to instruction (e.g., problem-based learning [PBL]), the use of multimedia to enhance self-directed learning, the use of an integrated curriculum to address basic and clinical sciences, and the introduction of new formative and summative assessment tools that match with the curriculum changes. However, several challenges face medical education and need to be carefully researched. The list may be long and these challenges may vary depending on the needs of local and international health systems, the availability of resources, the vision of medical leaders and how they see these challenges and their impact. This paper discusses a number of challenges facing medical education including the selection of medical students and the validity of selection tools, students' learning skills, what makes a good medical curriculum, and the challenges facing a PBL curriculum.