Who will teach? A fundamental challenge to medical education

The level of expertise possessed by medical school faculty members is unprecedented. Unfortunately, faculty members' broad understanding of their domains has atrophied as the specialization they need to compete successfully in the clinical and research arenas has increased. Medical students are novices, needing teachers who possess broad knowledge and experience, who can integrate the specific areas of a subject with overarching themes, and who can teach at the students' level. Clinical subspecialists and researchers on faculties often are ill-equipped to teach medical students. Likewise, busy clinical preceptors may no longer have the latest understanding of pathophysiology. The usual solution of bringing a series of basic science and clinical faculty members to classrooms and seminar rooms often results in disjointed coverage of material. Expanding the values of the university to once again include the scholarship of integration and teaching would provide the best type of faculty.