Medical school education for whom, student or patient.

Replace current student-oriented medical school teaching by a patient-focused education. Strengthen biomedical sciences, essential for the biomedical-scientist physicians of the future. Patient activities before biomedical science, behavioral and ethical studies do not educate: they exploit patients. Replace lectures of the first two years by students' designated reading followed by seminars and problem-solving. Current passive "fact"-oriented teaching needs change to one of student input, questioning, learning to cope with uncertainty, and taking responsibility for one's education. Ethics belongs in the curriculum and psychological history in medical records. Examinations determine teaching. Replace the multiple-choice-question examination with an evaluation that tests wide medical knowledge and includes a final thesis. Replace normative and pass/fail grading with criterion grading to a standard of excellence. Replace the obsolete nine months school year--with holidays only eight months of instruction--by 11 full calendar months, with holidays 10 full months of instruction.