Humanism in medical education: a study of educational needs perceived by trainees of three Canadian schools

The authors examined how medical trainees and recent graduates of three Quebec medical schools value 16 dimensions of medical competence classified in four broad categories: clinical, technological, humanistic, and social and preventive. To assess perceived educational needs, the trainees' perceptions of the importance that medical faculties attribute to these same dimensions in the education of physicians were also examined. The survey was conducted in 1986-87 via a questionnaire mailed to 2,030 individuals, including freshmen, juniors, interns, residents, and newly practicing generalists; 80.3% responded. Compared with the views attributed to the faculty, the medical trainees gave more importance to basic diagnostic and therapeutic skills such as the medical history, the physical examination, and the treatment of common diseases. They also valued to a greater extent non-biological dimensions of clinical competence, such as communication with patients, patient education, the social context of disease, and the multidisciplinary nature of patient care, while they ascribed less importance to medical technology and rare diseases. The study raises the question of the relevance of medical education to medical practice by suggesting that those who are preparing themselves to become doctors may not be receiving the training they wish to receive.