[Innovation of undergraduate medical education for future patient oriented medical care]

Recent supersubspecialization of medical sciences and technologies have developed DOS (Doctor/Disease Oriented System) in medical practice, and teaching of medical knowledge (cognitive domain) and techniques (psychomotor domain) have been overemphasized. However, the up-to-date knowledge and skills the students learn will become obsolete by the time they go into clinical practice. DOS has led to recognition of patient's rights and introduction of POS (Patient/Problem Oriented System) for the future medical practice with such concepts as holistic care, primary care, terminal care, truth telling, informed consent, quality of life, and death with dignity. What students must learn is not factual knowledge and techniques, but problem solving skills, habits for continuing self-education, and attitudes for holistic care of patients with proper communication skills. To attain such objectives, problem-based experiential self-learning methods and teaching communication skills through role playing, simulated patients, workshops, nursing practice, and clinical clerkship have been advocated. We introduced such new teaching strategies in our medical school about 10 years ago, and have been impressed by their effectiveness.