Ross-Lee B, Wood D L, Mann D D, Portanova R P, Kiss L E, Weiser M A
Ohio University College of Osteopathic Medicine, Athens 45701-1759, USA.
J Am Osteopath Assoc. 1997 Jul;97(7):403-8. doi: 10.7556/jaoa.1997.97.7.403.
Medical education has not kept pace with the evolving healthcare system. Criticism from industry and policy observers focuses on four major areas requiring reform: the curriculum, the fragmented educational infrastructure, the specialist-to-generalist mix, and the alienation from community and public health. The dominance of managed care organizations in the delivery and financing of healthcare is forcing a new set of physician competencies to the fore and changing projections of physician manpower and specialty needs. The authors address the four major criticisms from a uniquely osteopathic point-of-view. In this first of two articles, the authors describe the evolving osteopathic medical education model, and then employ a medical analogy to diagnose the causes of and propose treatments for curricular issues and infrastructure fragmentation. In the second article of the pair, they explore the causes of and propose strategies to address the generalist-to-specialist imbalance and the alienation of medicine from community and public health; the article also explores the role of technology in support of reform. In each article, the authors propose treatments to correct the problems in the osteopathic medical education model, and conclude that the profession is well-positioned to lead medical education reform.
医学教育未能跟上不断发展的医疗体系的步伐。行业和政策观察家的批评集中在需要改革的四个主要领域：课程设置、分散的教育基础设施、专科医生与全科医生的比例，以及与社区和公共卫生的脱节。管理式医疗组织在医疗服务提供和融资方面的主导地位，正迫使一系列新的医生能力凸显出来，并改变了对医生人力和专科需求的预测。作者从独特的整骨疗法视角探讨这四大批评。在这两篇文章的第一篇中，作者描述了不断发展的整骨医学教育模式，然后用医学类比来诊断课程问题和基础设施分散的原因并提出解决方法。在这两篇文章的第二篇中，他们探讨了全科医生与专科医生失衡以及医学与社区和公共卫生脱节的原因，并提出解决策略；文章还探讨了技术在支持改革方面的作用。在每篇文章中，作者都提出了解决整骨医学教育模式中问题的方法，并得出结论认为该行业有能力引领医学教育改革。
