Criticism of influences in medical education supposes at the very least an awareness of what these influences are. Some are readily identified; others are so subtle or disguised that they defy easy recognition; and all of them change almost as soon as they are recognized. The editor of the Journal of the American Academy of Arts and Sciences recently wrote1:
In a time of rapid changes, when almost all institutions assume new forms or show evidence of strain in seeking to accommodate themselves to unprecedented situations, there will always be a certain amount of disagreement about what in fact is taking place.
There will seldom be disagreement that what is taking place will be resented by persons or agencies whose presumed interests are served by continuing circumstances without change.
A story is told about a man who lived in a village outside Paris. During the revolution he met a
Miller CA. A Critique of External Forces in Medical Education. JAMA. 1965;192(10):837–841. doi:10.1001/jama.1965.03080230043011
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