Seddon T D
N Z Med J. 1985 Dec 11;98(792):1049-52.
In this brief review not all aspects could be covered. The main requirements for improvement are: Reorganise the Medical Council - expand the role of its educational committee and establish a curriculum advisory body. Begin a continuous evaluation process of medical education. Colleges and medical associations begin debating their role, involving lay organisations in the process. Curriculum committees and medical schools look at four areas of criticism (begin planning introduction of early clinical contact, problem solving, critical approach, self learning) and contemplate reduction in length of course. The direction of medical education following Flexner was the centres of medical excellence, these became the teaching hospitals and they have become the trap leading to a distorted view of medicine. That they have produced many advances is not disputed. That they will continue to do so is to be expected, although they are now retarding progress in the important and neglected areas that hold the most potential for benefit--prevention and primary care. The new direction of excellence must not be solely into institutions, but must now be into the minds of all the individual members of the profession. The institutions will change, as society does, along with increasing knowledge, but if possession of the habits of continual critical inquiry is equally represented in all members of the profession, then they will adapt more quickly and appropriately to the requirements in the future.
在这篇简短的综述中，无法涵盖所有方面。改进的主要要求如下：重组医学委员会——扩大其教育委员会的作用，并设立一个课程咨询机构。启动医学教育的持续评估过程。各学院和医学协会开始讨论各自的作用，让非专业组织参与这一过程。课程委员会和医学院审视四个受到批评的领域（开始规划引入早期临床接触、问题解决、批判性思维方法、自主学习），并考虑缩短课程长度。遵循弗莱克斯纳模式的医学教育方向是医学卓越中心，这些中心后来变成了教学医院，而它们如今已成为导致对医学产生扭曲看法的陷阱。它们取得了许多进展，这一点无可争议。预计它们将继续如此，尽管它们目前正在阻碍那些具有最大潜在益处的重要且被忽视领域——预防和初级保健——的进展。卓越的新方向不应仅仅指向机构，而现在必须指向该行业所有个体成员的思想。机构会随着社会的变化以及知识的增长而改变，但如果该行业的所有成员都同样具备持续批判性探究的习惯，那么他们将更快、更适当地适应未来的要求。
