Physicians for the 21st century. Challenges facing medical education in the United States.

Since the 1980s, the American medical educational system has come under attack for its failure to train and prepare physicians for the challenges created by the changing health care market. The medical schools have been criticized for producing too many specialists and for not providing sufficient training in ethics and moral reasoning, care of the terminally ill, health care economics, alternative medicine, and the role of spiritual and religious values in healing. This study attempts to ascertain the extent to which medical schools have responded to these criticisms by changing their curriculum. The study is based on a survey of deans of medical schools in the United States. The study finds that medical schools have indeed responded to some of the criticisms by incorporating training in ethics, communication, primary and preventive care, and care of the terminally ill in their curriculum. However, the study concludes that more changes are needed to train physicians for the 21st century.