Prevention in medical education: an uncertain future

There is reason for pessimism about the incorporation of prevention into medical education. In addition to what might be called the standard reasons for resistance to prevention, there are at least three other structural barriers: the destabilization of the health care system, the loss of interest in careers in primary care, and preventive medicine's failure to adopt a far-reaching critique of medicine and medical education. Only through linkages to progressive health care reform, to primary care, and to the biopsychosocial model can prevention achieve an important place in medical education.