In the same fifty-year time period from World War II to the present, when there were major changes in medical practice and in the development of medical ethics, medical education remained essentially the same.
Then in the late 1980s, medical ethics was introduced as a subject of study in medical education. Some background on medical education will explain the interrelationships between medical education, medical practice, and medical ethics and the changes that were and are occurring in medical ethics education.
Medical schools, designed exclusively for the education of physicians, are jointly accredited by the Association of American Medical Colleges (AAMC) and the American Medical Association through the Liaison Committee on Medical Education (LCME). Since 1910, medical education has been standardized across the United States and Canada: all medical schools have a four-year, common core curriculum that includes study in both the basic and clinical sciences. In addition, all states require one year of residency for licensure.
The curriculum has centered on scientific facts, organ systems, and diseases. Subjects that were not ‘’science” were not taught. “Medical training” is a major part of medical education. In the medical training programs, physician educators train all medical students in areas such as surgery, pediatrics, and Ob-Gyn. Medical training is inseparable from medical practice, that is, the treatment of patients.
Physician-educators at AMCs provide medical care for their patients at the same time that they are providing instruction to medical students. Medical students and residents work with senior physicians to learn scientific, technical, practical and interpersonal skills. Patients and their medical problems and treatments serve as the instructional material.
Medical students and residents have to pass three levels of national exams, U.S. Medical Licensing Exams (USMLE), to practice medicine as physicians. Most new physicians then train as specialists with focused expertise in state-of-the-art technology to keep pace with scientific changes. In order to specialize, physicians must receive an additional two to seven years of intense post-graduate training in residency programs. There is little time anywhere in the current curriculum to given to non-scientific matters.