Procedural skills: What's taught in medical school, what ought to be?

Background: Medical schools' instruction of skills is often found to be inadequate. In 1999, the American Association of Medical Colleges (AAMC) published a list of eight procedural skills that medical students are recommended to learn. This study aims to evaluate compliance with these guidelines and to examine the instruction of other skills to determine if the most important skills receive adequate instruction. Methods: In 2004, surveys were sent to 138 educational representatives at North American (AAMC) medical schools and 1208 Canadian family physicians. The survey addressed the importance of selected skills. Findings were analyzed by chi(2) testing. Results: Of the eight skills recommended by the AAMC, only four were taught by all schools. All eight, except for suturing, and most of the other skills, were taught at a higher rate than they were practiced. Only digital block anesthesia was practiced more commonly than it was taught. Conclusion: Although guidelines exist for skills instruction in medical school, they are not followed completely. Furthermore, the guidelines may reflect an emphasis on skills that are more suited to specialist rather than general practice. This may come at the expense of the instruction of other more practical skills.