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4 Changing Medical Education
Pages 44-51

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From page 44...
... In its own way, each report emphasizes the need for medical schools to place students at the center of their missions, and each urges the schools to prepare their students to meet the changing health care needs of the American public (Association of American Medical Colleges, 1992a)
From page 45...
... . Many of the reform proposals pose opportunities for integrating environmental medicine into medical education in the sense that: environmental medicine is responsive to the calls for cross-disciplinary teaching; environmental medicine melds basic and clinical science and reinforces the basic and biomedical sciences throughout the course of medical study; it moves training away from tertiary-care teaching hospitals and into the community; and it emphasizes student-directed, problem-based learning (Association of American Medical Colleges, 1992a,b; Marston, 1992; O'Neil, 19921.
From page 46...
... In response to concerns about traditional medical curricula, innovative new programs of undergraduate medical education have emerged within the past decade (Anderson, 1993~. The content and structure of some of the new programs share some common features, each of which is relevant to an environmental medicine curriculum: · more interdisciplinary courses that integrate basic and clinical sciences an opportunity easily realized in environmental medicine; · an emphasis on the mastery of biological concepts; · content related to social and behavioral aspects of health and disease; and · ambulatory and community clinical experiences that teach health care organ~zation, practice, and financing.
From page 47...
... These barriers were identified repeatedly by respondents to the ACME-TRI project survey and represent key elements that must be altered, or overcome, if meaningful change is to occur in the medical school curriculum, including the integration of environmental medicine. In any attempt to change the manner or content of instruction in medical schools, it is important to keep several realities in mind regarding time constraints and competing demands.
From page 48...
... a small but promising set of programs that support the development and integration of environmental medicine into medical education and practice. Prevention and Future Health Care \ The competency-based learning objectives set forth in Chapter 2 conform to several tenets underlying some of the current evolutionary trends in health care.
From page 49...
... With or without substantial changes in the health care system in the United States, prevention is likely to play a larger role in the future practice of medicine, providing opportunities for the integration of Environmental medicine into both education and practice. Table I
From page 50...
... , one of the principal federal agencies for biomedical research on the effects of chemical, physical, and biological environmental agents on human health and well-being. These NTEHS sponsored programs include the Environmental/Occupational Medicine Academic Awards to medical school faculty members for improving environmental/occupational medicine curricula, and the Environmental Health Sciences Center Awards to universities for conducting multidisciplinary research in environmental health.
From page 51...
... Although deep structural resistance to such change is inherent in the organization of medical schools, the current cInnate of expectation with respect to an increased emphasis on prevention in health care, a paradigm shift in the knowledge base, and the successes of the limited numbers of programs that support the integration and enhancement of environmental medicine in medical education are favorable to progress toward these goals. Insofar as the prospect of integrating environmental medicine into the medical school curriculum constitutes a response to the calls for curriculum reform, the climate offers opportunities for taking immediate action to enhance the content of envirorunental medicine in both medical education and practice.


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