Honoring the "E" in GME.

Medical educators should realize that the public's complaints about doctors--that they don't care enough about their patients, don't know enough to practice the best medicine, and don't do enough to maintain the public's trust--are exaggerations of the truth but highlight areas demanding improvement in the educational component of graduate medical education (GME). In addition to continuing to prepare residents for the demanding technical challenges they will face as physicians, those involved in GME need to (1) enrich significantly the educational content of residency programs; (2) promote the coordination, strengthening, and potential consolidation of the institutional responsibility for these programs; (3) reorder programs' priorities to make room for the added educational content, which means limiting service requirements to those necessary to meet prospectively defined educational goals; and (4) recognize the power of the hidden curriculum in communicating professional values, and thus modify significantly the way residents are treated. The author explains these recommendations in detail and notes a variety of ways that the Association of American Medical Colleges intends to help educators make these needed changes. He concludes by stating that a "time bomb" is ticking: many sectors of the public and many patients are becoming impatient with doctors. "Listening hard to their complaints and finding appropriate remedies is a must if we are going to ... answer our critics ... and continue to provide America with the world's best doctors."