Predoctoral education in family medicine: a ten-year perspective

The educational goals chosen by teachers of family medicine for predoctoral students a decade ago differ substantially from the present goals. The original goals were to increase the number of family physicians, provide them with the basic knowledge and skills to practice, integrate the concepts of family medicine into the total medical school curriculum, and develop the "attitudes and ideals" of the good family physician. A series of basic learning principles were evolved to attain these goals. These included: teach in a practice setting, focus on persons rather than disease processes, use a team approach to teaching, involve students in the planning and evaluation process, and recognize curriculum development as a dynamic process. The present curriculum has an increased emphasis on clinical skills in family practice and on integration of behavioral science; there is a new emphasis on the role of the physician in the community and a better understanding of health care systems. Future directions for family medicine include increasing the emphasis on interpersonal communications, clinical synthesis, and clinical assessment.