PROBLEM-BASED LEARNING

The accelerating growth and differentiation of knowledge in the sciences basic to medicine raise interesting and important issues for the future of medical education. The corpus of potentially relevant information is too large for any individual to master during the medical school years. Rather, the goal must be for each student to develop the commitment, skills and a framework of knowledge that will sustain a lifetime of learning in medicine. For example, today's students will bear witness to the complete mapping and sequencing of the human genome, bringing with it a much more sophisticated awareness of the susceptibility of each individual to environmental risks, and thus a more effective preventive medicine, and the realistic prospect of gene therapy. The power of molecular medicine brings into practical focus social, economic, legal and ethical concerns that were not long ago largely theoretical for practising doctors. These interrelated dimensions of modern medicine suggest that a specialty‐ and discipline‐dominated approach to medical education is no longer sufficient to meet the needs of future doctors. Rather, the traditional didactic pattern should be tempered by exercises that will allow students to encounter simultaneously the physical, chemical, biological, social, ethical, legal and economic aspects of actual clinical problems. Such experiences allow students the opportunity to develop the attitudes and skills necessary to solve the problems that they confront in clinical practice. This paper describes some of the problems used in the program of New Pathways of General Medical Education now in progress at Harvard University. I am grateful to the organizers of this World Summit on Medical Education for the opportunity to learn with you during the past three days. Particular thanks are due to Henry Walton, whose vision animates our deliberations. 1994 Blackwell Publishing