Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Acad Med. 2010 Feb;85(2):333-9. doi: 10.1097/ACM.0b013e3181c874cb.
A century after the publication of Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching (the Flexner Report), the quality of medical education in much of Asia is threatened by weak regulation, inadequate public funding, and explosive growth of private medical schools. Competition for students' fees and an ineffectual accreditation process have resulted in questionable admission practices, stagnant curricula, antiquated learning methods, and dubious assessment practices. The authors' purpose is to explore the relevance of Flexner's observations, as detailed in his report, to contemporary medical education in South Asia, to analyze the consequences of growth, and to recommend pragmatic changes. Major drivers for growth are the supply-demand mismatch for medical school positions, weak governmental regulation, private sector participation, and corruption. The consequences are urban-centric growth, shortage of qualified faculty, commercialization of postgraduate education, untenable assessment practices, emphasis on rote learning, and inadequate clinical exposure. Recommendations include strengthening accreditation standards and processes possibly by introducing regional or national student assessment, developing defensible student assessment systems, recognizing health profession education as a field of scholarship, and creating a tiered approach to faculty development in education. The relevance of Flexner's recommendations to the current status of medical education in South Asia is striking, in terms of both the progressive nature of his thinking in 1910 and the need to improve medical education in Asia today. In a highly connected world, the improvement of Asian medical education will have a global impact.
《美国和加拿大的医学教育：卡内基教学促进基金会报告》（Flexner 报告）发表一个世纪后，亚洲大部分地区的医学教育质量受到监管薄弱、公共资金不足和私立医学院激增的威胁。为了争夺学生的学费和无效的认证程序，导致了可疑的录取做法、停滞不前的课程、过时的学习方法和可疑的评估实践。作者的目的是探讨 Flexner 在报告中详细阐述的观点与南亚当代医学教育的相关性，分析增长的后果，并提出务实的变革建议。增长的主要驱动因素是医学院职位的供需不匹配、政府监管薄弱、私营部门参与和腐败。其后果是城市化增长、合格教师短缺、研究生教育商业化、评估实践不可持续、死记硬背强调和临床实习不足。建议包括加强认证标准和流程，可能通过引入区域或国家学生评估、开发合理的学生评估系统、承认健康职业教育是一个学术领域以及为教育制定教师发展的分层方法。就 Flexner 在 1910 年的前瞻性思维以及今天亚洲改善医学教育的必要性而言，Flexner 建议对南亚当前医学教育状况的相关性引人注目。在一个高度互联的世界中，亚洲医学教育的改善将产生全球性影响。
