Missions of a medical school: a North American perspective

Despite its strong reputation and obvious accomplishments, medical education in the United States needs to address five areas in which its products and processes are not sufficiently aligned with society's expectations. First, medical education must address the escalation of health care costs by placing greater emphasis on teaching evidence-based medicine. Second, the current overproduction of medical specialists must be changed in favor of educating generalist physicians. Third, physicians must become more skilled in working with patients and populations to alter poor lifestyle choices. Fourth, medical education should contribute to meeting the health care needs of the medically underserved by ensuring a physician population that is racially and ethnically diverse. Finally, medical education must address the erosion of trust that has occurred between physicians and their patients by emphasizing the primacy of the patient's interest in all that a physician does.