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September 3, 1997

Predominance of the Curative Model of Medical Care: A Residual Problem

Author Affiliations

From the Section on End-of-Life Care, Institute for Ethics, American Medical Association.

JAMA. 1997;278(9):761-763. doi:10.1001/jama.1997.03550090085038

Despite a multitude of efforts in recent years to reform medical education, and despite the significant gains that have been achieved, some refractory problems remain. Two articles in this issue of The Journal describe persistent shortcomings in the present medical education system. Billings and Block1 summarize the results of an extensive literature review of end-of-life education in medical schools, concluding that the training currently provided inadequately prepares students to care for dying patients. Christakis and Feudtner2 describe anecdotal experiences of medical students and residents on inpatient services, illustrating how the transitory and time-pressured nature of that environment can have disturbing effects on trainees' ethical development. On the face of it, these two articles may seem to have little in common. On a deeper level, however, these articles share a common theme: Both can be construed as serious critiques of medical education's prevailing overemphasis on a curative model of