The internal challenges to medical education.

This presentation shall discuss the major "internal" challenges to medical education--that is, challenges to achieving effective medical teaching that have arisen from the evolution of the science and practice of medicine. These issues are defined as "internal" in that they reflect the internal evolution of the profession and of academic medical centers, independent of the perturbations in medical education we are presently experiencing as a result of the hostile external environment of health care. Examples of these internal challenges include the growing "bench-bedside gap," the traditional tensions at medical schools between teaching and research, and the need to adjust medical education to meet the challenges imposed by chronic diseases. The need for "internal" leadership from within the profession to help solve some of the "external" problems of medical education shall also be discussed.