Seddon T D
N Z Med J. 1985 Oct 23;98(789):907-10.
Overall what is suggested is a tried and proven apprentice type system, with continuing role models, more stable patient care teams, defined educational objectives, all with some flexibility and a reduction in the tendency to over supply in specific areas. The transition would be difficult, it could not happen without change (already suggested) in the undergraduate curriculum and it would also require changes in other areas, peripheral to the areas of hospital organisation already discussed. The changes necessary for the full effect of these proposals to be felt, will be those occurring in medical society. The changes will be in the methods of practice, in organisation and payment and in the relationship of different parts of the profession (aiming for abolition of the dichotomy existing between primary care and the hospital), all sections taking an active part in planning and delivering medical education. A clear commitment must be made to continually evaluate medical education's performance and relevancy, connecting this to institutions (medical schools, hospitals, colleges etc) geared and prepared to respond. A reconstituted and reorientated Medical Council would be pivotal to this being successful. This two year spell inflicted on the young members just entering our profession is inexcusable in humanitarian terms, wasteful in educational terms, and ineffective in management terms.
总体而言，建议采用一种经过实践检验且行之有效的学徒制体系，配备持续的榜样人物、更稳定的患者护理团队、明确的教育目标，所有这些都具备一定灵活性，并减少特定领域供应过剩的趋势。这种转变将很困难，若本科课程没有变革（已有人提出），它就无法实现，而且还需要在其他领域进行变革，这些领域与已讨论的医院组织领域相关但处于边缘位置。要充分感受到这些提议的全部效果，所需的变革将发生在医学社会。变革将体现在实践方法、组织与薪酬以及该职业不同部分之间的关系上（目标是消除初级保健与医院之间现有的二分法），所有部门都要积极参与医学教育的规划与实施。必须明确承诺持续评估医学教育的表现和相关性，并将其与有能力且准备好做出回应的机构（医学院、医院、学院等）联系起来。一个经过重组和重新定位的医学委员会对于此事的成功至关重要。从人道角度看，强加给刚进入我们这个职业的年轻成员的这两年期限是不可原谅的，从教育角度看是浪费的，从管理角度看是无效的。
