Practical reform of preclinical education: core curriculum and science projects

This essay proposes reform of the preclinical curriculum which is seen as deficient in both content and method. The period of preclinical study should have a dual purpose: to provide a vocational training in basic scientific knowledge essential to good clinical practice, and to educate medical students in the methods and skills of science. These purposes are best separated. The vocational element constitutes a core curriculum which could be constructed from a consideration of the basic scientific knowledge used by clinicians in their medical practice. A core curriculum could be prepared and examined on a national basis, and would provide a means for quality control of medical education. The timetable space thus liberated would be used for project work in medical sciences, using the teaching methods of science degrees. The proposed curriculum combines the discipline of vocational relevance with the educative potential of an honours BSc, but with no requirement for increased resources or alterations in manpower. It may be seen as a shift from theory towards practice during preclinical study. Strategies for introducing such a system are discussed.