Viewpoint: New physicians for a new century

How to train competent and compassionate physicians has assumed a new urgency. The authors propose that these concerns be approached by radically restructuring the medical school curriculum in ways that place facts and skills within the context of ethics and values. Doing so will require that the positivist stance of medical education be coupled to strategies that deal with ambiguity and uncertainty, communication and empathy, and, most important, physician self-awareness. Achieving such balance will require fundamental change in medicine's education philosophy along five general lines: (1) assertion of medical ethics as the foundation of clinical medicine; (2) recognition of the central place of values in clinical decision making; (3) cultivation of the ethos of humane care; (4) selection of medical students with the dual capacities of strong cognitive skills and empathy; and (5) encouragement and support of faculty who can transmit the knowledge of clinical science coupled to the principles of humane care. Such changes are both timely and necessary. Although they will be difficult to accomplish, they offer an opportunity for medical educators to foster the development of physicians with the range attributes that this new century demands.