Training of physicians for the twenty-first century: role of the basic sciences.
BACKGROUND
Rapid changes in the healthcare environment and public dissatisfaction with the cost and quality of medical care have prompted a critical analysis of how physicians are trained in the United States. Accrediting agencies have catalyzed a transformation from a process based to a competency-based curriculum, both at the undergraduate and the graduate levels.


OBJECTIVE
The objective of this overview is to determine how these changes are likely to alter the role of basic science in medical education.


METHODS
Policy statements related to basic science education from the National Board of Medical Examiners (NBME), the Accreditation Council for Graduate Medical Education (ACGME), American Board of Medical Specialties (ABMS), and the Federation of State Medical Boards (FSMB) were reviewed and assessed for common themes.


RESULTS
Three primary roles for the basic sciences in medical education are proposed: (1) basic science to support the development of clinical reasoning skills; (2) basic science to support a critical analysis of medical and surgical interventions ("evidence-based medicine"); and (3) basic and translational science to support analysis of processes to improve healthcare ("science of healthcare delivery").


CONCLUSIONS
With these roles in mind, several methods to incorporate basic sciences into the curriculum are suggested.
Grande
Joseph P
JP
Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA. grande.joseph@mayo.edu
D000068:Accreditation; D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical / Q000592:standards*; D019317:Evidence-Based Medicine; D005180:Faculty, Medical; D006801:Humans; D010820:Physicians / Q000592:standards*; D012586:Science / Q000193:education*; D013337:Students, Medical; D014481:United States