A vision of quality in medical education.

This paper begins with historical and other reflections on the nature and importance of quality in medical education. It then identifies and discusses missions of a medical school--which include teaching, research, medical service, continuing education, and social advocacy--and notes that these elements should be complementary and indeed synergistic. Components of quality, both of a medical graduate and of a medical school, are then considered. After discussing the use of examinations to assess quality of graduates, the paper concludes by calling for a total quality approach to medical education, with due attention to input, process, and output.