Toward a liberal education in medicine.

The central thesis of Abraham Flexner's analyses of North American and European medical education was that the university is essential to the provision of a medical education. The authors invoke the spirit of Flexner to envision further contributions of the university at large to undergraduate medical education. Medical curricula now include elements of a variety of other disciplines that are better represented in other parts of the university. Most schools, however, even those closely affiliated with a comprehensive university, do not take full advantage of these resources, nor do they offer sufficient opportunities for students to pursue individualized interests and learning goals. Medical school now plays a different role in the education of physicians than it did a century ago-it remains the definitive, but is no longer the ultimate, stage in a continuum involving college, professional, postgraduate, and continuing education. The authors explore the medical school years as an opportunity for a liberal education in medicine. Beyond the assurance of competence in core knowledge, skills, and perspectives, this model places more emphasis on nurturing students' intellectual curiosity about phenomena of illness and disease, their understanding of the human condition, and their exploration of the many other disciplines related to medicine and the life sciences. A richer, broader education can be achieved through more flexible and individualized paths to the MD and facilitated by realizing medical schools' full academic citizenship in the university.