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January 10, 1994

Changes in Undergraduate Medical Education-Reply

Author Affiliations

Honolulu, Hawaii

Arch Intern Med. 1994;154(1):109. doi:10.1001/archinte.1994.00420010142020

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


The clinical clerkship is the crucial experience in medical student education. To be learned effectively, bioethics, decision analysis, demographics, medical sociology, and many other important topics must be attached to a patient-centered problem; separate lectures and seminars are insufficient. This was part of the message of my article, and Fretscher supports it with his personal experience. He also suggests that non—patient-centered pedagogic efforts sometimes may be counterproductive and, in his experience, generate negative sentiments.

The challenge to medical educators is to incorporate these vital issues into the student-patient clinical encounter.

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