Looking forward-looking back: aspects of the contemporary debate about teaching and learning medicine.

Does the tired oppositional debate between student-centredness and teacher-centredness leave the patient stranded, where the patient is surely the focus of a medical education? How might an authentic patient-centred practice be shaped, informed and nourished theoretically? We describe an intellectual landscape of critical, interdisciplinary inquiry that, so far, many medical educators have not inhabited. For example, texts written to inform medical education rarely examine intellectual premises and ideological implications. We offer a number of theoretical frameworks that can inform critical practice, asking 'why do we do it this way?'; 'what are the alternatives?'; and 'how do we justify our approaches intellectually?' We conclude that medical education needs to take stock of its intellectual resources.