Improving the way we educate medical students: a priority for the 1990s

The repeated calls for change in the last 80 years regarding how we educate medical students have met with resistance and inertia. Position papers on why change should occur and what the outcomes should be have been presented since the 1930s, but the missing essential ingredient in each of those documents has been how to implement change within the context of the medical school organization and environment. Recognizing this deficiency, the Association of American Medical Colleges convened a task force, which, among other things, surveyed medical school administrators to determine how they were effecting change in their own institutions. Based on results from respondents, the task force published the ACME--TRI report, an acronym for assessing change in medical education--the road to implementation. This article offers suggestions on how to implement parts of the ACME--TRI report.