The internal medicine clinical clerkship: opportunities for improvement

We have witnessed a recent explosion of new knowledge in medical education. The use of creative teaching methodologies, curriculum development and the recognition of medical education as a field ripe for research and investigation have occurred at many medical schools in Europe and North America. However, most of this innovation has occurred in the pre-clinical years and very little has been transferred to the clinical setting. The use of comprehensive curricula with goals and objectives, problem-based learning (PBL), a renewed emphasis on physical diagnosis, evidence-based medicine (EBM), patient-centered interviewing, ambulatory education, computer-based learning and new methods of assessment all need to be introduced into the clinical clerkships while ensuring that the majority of learning still takes place through the student-patient interaction at the bedside. By virtue of its traditional excellence in medical education, internal medicine has the opportunity to take the lead in revitalizing clinical education by building on our successful past and leading the other disciplines into the future.