Campaign to revitalise academic medicine: Some thoughts for academic revisionists to consider

BMJ 2004;328:1378 (5 June), doi:10.1136/bmj.328.7452.1378

Letter

The first 150 words of the full text of this article appear below.

EDITOR—Fundamental revision of academic medicine¹ mightstart by considering:

Expanding medicine's biomedical world-view to include the impactsof social, emotional, environmental, familial, and occupationalfactors on health and disease
Expanding major educationalvenues beyond the hospital to doctors'offices, patients' homes,nursing homes, rehabilitation units,and hospices
Replacingthe emphasis on single "causes" for most diseaseswith profilesof predisposing, precipitating, and perpetuatingfactors thatrecognise clusters or sequences of the severalelements requiredto evoke biological or behavioural changes—forexample,genes, diet, and sedentary lifestyle for diabetes;strong coffee,ageing, and stress for atrial fibrillation; poverty,depression,and the tubercle bacillus for tuberculosis; climatechange,stress, depression, and a virus for the common cold
Requiringgraduates to be knowledgeable about current concepts,methods,contributions, and limitations of clinical, biomedical,behavioural,and population perspectives in medicine
Shrinking basic sciencecourses and incorporating their principlesin longer exposuresfocused . . . [Full text of this article]