Intended for healthcare professionals

The Impact Of Informatics

Universities without walls: evolving paradigms in medical education

BMJ 1999; 319 doi: (Published 13 November 1999) Cite this as: BMJ 1999;319:1296
  1. Roderick Neame, senior lecturer (,
  2. Brooke Murphy, senior associateb,
  3. Frank Stitt, vice-chancellorc,
  4. Mark Rake, deana
  1. a Kent Institute of Medicine and Health Sciences, University of Kent, Canterbury, Kent CT2 7PD
  2. b Health Information Consulting, Homestall House, Faversham, Kent ME13 8UT
  3. c International University of the Health Sciences, Basseterre, St Kitts, West Indies
  1. Correspondence to: R Neame, Health Information Consulting, Homestall House, Faversham, Kent ME13 8UT

    Medical education is entering a phase of renewed change driven by developments in information availability and technology. Over the past half century medical education has remained largely isolated from the changes that have swept through most other businesses: enterprise-wide computerisation, client centred thinking, and a service philosophy.

    The clients of the medical education process, who, worldwide, generally pay for themselves (though in some countries they are state funded) are guaranteed little for their money, often not even a modern, efficient, or entirely relevant educational programme. Many leave medical school financially poorer and often little enriched cognitively: they are generally weighed down under a vast burden of obsolescent information, the important elements of which could be found by an intelligent member of the lay public faster and in an updated form directly from the world wide web. They are also changed culturally, not necessarily for the better. Their time spent studying in the academic ivory towers, from which most graduate, separates them from their community roots and also reinforces the divide between primary and secondary care and does little to emphasise the essential humanity and caring intrinsic to this vocation.1

    Summary points

    A wealth of information about biomedicine and health care is available in electronic formats, and this can be synthesised into courseware for medical education and distributed electronically

    For many, the study of small or larger parts of medicine could be a recreational pursuit; for others, it might be a vital venture in self understanding in order for them to manage health risks and play a greater part in decision making about their health

    For much of the time, course developers, tutors, and students can readily be separated in time and space and effectively linked by electronic communications: there is no need for co-location of all resources at a single site …

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