[Medical education of tomorrow: a glance into the (near) future]

Educational reform is a topical subject in Dutch medical schools. Public visitation reports were issued in 1992 and 1997. In 1994 an 'outline plan' was presented, setting forth communal training requirements (final results). An important consequence will be reorganization of (assistant) housemanships. Options are to start already in the 3rd- and 4th-year with a few (assistant) housemanships, to reduce the number but increase the duration of the (assistant) housemanships and to introduce a more comprehensive training (including elements from several disciplines). Other areas for special attention are the insufficient professionalization of teachers in medicine, the bureaucracy weighing down the teaching and the continuing need of educational research. Regarding the future doctors' image of their profession, emphasis should be placed on the international trend toward more attention for prevention and cost control, apart from the physician's traditional curative task. With respects to curriculum reorganization, six items should be considered: the need of a basic philosophy (per faculty), the priority to be given to the process of medical problem solving over that of acquiring knowledge and information, the desirability of increasing orientation to practice, the necessity of an integrated approach of medical teaching (teaching elements to be deduced from the final terms, instead of vice versa), development of a professional attitude and the realization of a master-apprentice relationship in medical education.