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March 5, 1973

Medical Education: Is There a Crisis?

JAMA. 1973;223(10):1155. doi:10.1001/jama.1973.03220100049014

When JAMA published the editorial, "Entry to medical school: An idle hope" (221:1407, 1972), a diligent reader commented that the cost of getting into medical school and staying there and the problems of determining qualifications of too many applicants are less important than the kind of physician the educational system produces. Presumably, our reader-correspondent was worried about the effects of educational experiments in academic medical centers. Perhaps he views present-day, medical student-house officer experiences as a "nonsystem"—the odious word so often applied to existing medical practices.

Certainly, George L. Engel1 holds the concern that prevailing and proposed modifications of medical education threaten its very fabric. Writing from a background of 30-years' dedication to imparting "to medical students and house officers the clinical approach to the patient," he fears that curriculum changes in medical schools, especially the trend toward shortening undergraduate experience, and abolition of the internship may create a