The main challenges

The last few decades have witnessed dramatic changes, not only in health, but also in all aspects of human life. From the social point of view, the individual and family are again becoming the focus of attention, and there is an increasing concern about socio-economic conditions and human rights. From the health point of view, morbidity and mortality patterns are changing and many people live longer and fewer people die. The reasons behind these changes are mainly the expansion in knowledge and technology and the concern about our lifestyles. These changes impact heavily on both medical education, the delivery of health services, and the cost of health care. Medical schools should respond by introducing changes in the medical education process and ensure the proper training of a new generation of doctors who are community- and socially oriented, capable of relating to the community and its needs. The health care system should also respond to these changes by restructuring its organization and finance to ensure quality in health care and that health services are not rationed according to an individual's ability to pay. There are apparent advantages in establishing close links between medical education and health care. Both systems and the community stand to gain from these links. Full integration of the two systems could be the final objective but should be preceded by careful study and experimentation.