The graduates of medical education institutions should be, both in their numbers and in their acquired skills, appropriate to improving the health of the particular society they are intended to serve. Medical education should be tailored to deal with the diseases the physician is most apt to see — or at least apt to see in an academic medical center. Such logic does not prevail, however, in terms of either the numbers of physicians trained or the content of the medical curriculum. The Western model of a medical school curriculum has been adopted— but little adapted—for use by much of the Third World. Relevant subjects such as epidemiology, social sciences, and management are often either ineptly taught or omitted. A shift in attention from patient to community is recommended, accompanied by deliberate programs of education and health care to measure and improve the health of the community. Significant improvements in health in much of the world can be made only through community-based programs such as improved nutrition, education, sanitation, prevention of infectious diseases, and family planning. Two types of U.S. participation in international medical education are recommended: (1) specialty training of physicians from countries whose access to instrumentation and medical care support structures are similar to those in the United States, and (2) strengthening of institutions in developing countries in the areas of education, research, and practice appropriate to the particular needs of each of these countries. Acad. Med. 64, Supplement 1(1989):S9-S12.
© 1989 by the Association of American Medical Colleges