2011; 33: 517

COMMENTARY

Tomorrow’s curriculum for tomorrow’s doctors

TRUDIE ROBERTS

University of Leeds, UK

The future is that period of time in which our affairs

prosper, our friends are true, and our happiness is

assured

A. Bierce The Devil’s Dictionary

Long experience has made me reticent about trying to

predict the future. Recent events in the finance and political

world have confirmed that view. In medicine this is also true.

As a student I watched senior surgeons perfect the technique

of highly selective vagotomy only to have this all swept away

by the discovery of proton pump antagonists. New diseases

such as HIV/AIDS have brought new knowledge and

treatments and with them have changed the educational

requirements of doctors. How then, do we as medical

educationalists ensure that new medical graduates are

equipped to fulfil their role as providers of high quality

healthcare? At the AMEE conference 2010 in Glasgow, we held

a symposium to discuss what the future medical school

curriculum might look like. We invited a range of stakeholders

to present their views. These stakeholders included a medical

regulatory body, junior and senior clinicians, an employer and

a patient. The presentations were all excellent and thought

provoking in very different ways. A number of the people who

spoke at that symposium and others who presented on topics

addressing the area of educating future doctors have

contributed to this special issue of Medical Teacher.

What do these contributions tell us about what we should

do and how we need to change our curricula? Irby discusses

the standardisation of learning outcome within an individual

context. He emphasises the value of integrating knowledge

and practice and the need to ensure graduates contribute to

the continuing high quality of clinical care by the qualities of

continued enquiry and lifelong learning. But perhaps his most

important recommendation is for medical curricula to explicitly

address the understanding of what it means to be a medical

professional. This is interesting because although other

disciplines such as sociology have long had an interest in the

formation of professional identity, there has been much less

research within the medical profession as a whole probably on

the assumption that merely being part of ‘the club’ means that

you unconsciously absorb what it means to be a doctor.

Krackov and colleagues use the framework of deliberate

practice to develop skill formation and demonstrate its

inclusion into the medical course using the example of a

nutrition-based curriculum module. van der Lee and others

look at the applicability of the CanMEDS roles and current

health service delivery in obstetrics and gynaecology. In

addition to validating the current CanMEDS competencies they

identified two additional roles, those of advanced technology

user and entrepreneur that were necessary for modern and

future practice.

Murdoch-Eaton and colleagues address the area of global

travel and migration and the effects on the medical practice

of all doctors. This theme is taken up and further developed

by Lindgren and Gordon in their piece on the global role of

doctors. Their view and a main theme of the work of the

World Federation for Medical Education is to agree themes

relevant to the role of the doctor globally, and developing a

statement that can be used world-wide, and used to develop

medical education policy. But by concentrating on the global

do we risk not acknowledging the importance of the ‘local’

cultural context in which medicine is actually practised?

The paper by Hemmer et al. brings together many of the

major luminaries to address the content of medical education

in the twenty-first century linking to the changes brought about

by Abraham Flexner a century earlier. Although one of the

authors is quite rightly a medical student, one could argue that

the most importance voice – the patient – is notably absent.

Fortunately, this is remedied by the excellent contribution from

Elaine Brock. How interesting it would be to fast-forward to

the future and look whether these suggestions stand the test of

time. Whatever the next 100 years brings let us hope it does

not take that long for the patient’s voice to become a little more

centre stage.

Declaration of interest: The author reports no conflicts of

interest. The author alone is responsible for the content and

writing of this article.

Notes on contributor

TRUDIE ROBERTS, BSc, MBChB, PhD, FRCP, is a Consultant Physician, a

professor of Medical Education and the director of the Leeds Institute of

Medical Education.

Correspondence: T. Roberts, Medical Education Unit, University of Leeds, Level 7, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK.

Tel: 44 01133431657; fax: 44 01133434910; email: t.e.roberts@leeds.ac.uk

ISSN 0142–159X print/ISSN 1466–187X online/11/070517–1 � 2011 Informa UK Ltd. 517DOI: 10.3109/0142159X.2011.578179

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