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American Medical Schools and the Practice of MedicineA History$
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William G. Rothstein

Print publication date: 1987

Print ISBN-13: 9780195041866

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195041866.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 05 December 2021

Policy Making in Medical Schools

Policy Making in Medical Schools

(p.5) 1 Policy Making in Medical Schools
Title Pages

William G. Rothstein

Oxford University Press

Medical schools today are being closely scrutinized. Questions have been raised about their educational policies, the activities of their faculty members, and the quality of care provided in their clinical facilities. The concern is due in part to the activities of the medical schools themselves, in part to their accountability for use of government funds, and in part to changes in the American health care system. It is thus appropriate to examine the history of American medical schools to understand how the central issues in medical education have changed and how medical schools have responded to the changes. In this study, medical schools in each period have been placed in the context of that period. Their educational policies have been analyzed in terms of the state of medical practice of the time. Their educational standards have been compared to those of other institutions of higher education. This chapter will develop a framework for the analysis by examining the major issues and groups involved in medical education. The casual reader may wish to know that this framework is not essential for understanding the historical narrative, and that each part of the narrative can be read independently. Because medical education is designed to prepare students for employment as physicians after graduation, a fundamental pedagogical issue concerns how to balance the need to teach students the basic concepts of medical science with the need to train them in the practical skills needed to practice medicine. This becomes particularly difficult when the two bodies of knowledge are as intellectually demanding and as different as they are in medicine. The science and practice of medicine, in their broadest sense, are concerned with the structure and functions of the human organism in health and disease, the causes of change from one to the other, the prevention of disease, and the means of restoring health when disease occurs. Medical science is concerned primarily with the first two of these, medical practice with the last three. Medical practice also involves a social and economic relationship between a patient and a physician. The patient agrees to compensate the physician, either directly or through a third party.

Keywords:   Decision-making theories

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