Reform and innovation: a repeating pattern during a half century of medical education in the USA

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Abstract
Medical education in the USA today is remarkably varied despite the shared mission of training doctors. A brief introduction to 6 institutions illustrates the variety of education available, while providing some specific details of how schools differ and how the mandate of any particular school may differ from that of another. Private schools include Dartmouth Medical School, Duke University School of Medicine, and Mount Sinai School of Medicine. State-supported schools include the University of Arizona College of Medicine, Oregon Health and Science University School of Medicine, and Southern Illinois University School of Medicine. General remarks are made about changes over recent years in three separate areas of influence. Forty new medical schools were established between 1960 and 1980; a brief explanation is provided of the reasons for this and how it was achieved. A few of the numerous new emphases that have been introduced into the medical school curriculum are discussed briefly. A small sample is given of ways in which particular medical schools have reformed their curricula over the years. What went into the most influential curricular reform is presented, along with mention of what are perhaps the most unusual curricular paths today. The paper concludes with an assessment of where reforms have brought US medical education by the beginning of the 21st century and what needs yet to be accomplished.

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