進化する医学教育

Education about medicine has an ancient history. It seems to me that it is probably the oldest part of the history of education. In the time of the ancient Greeks, Hippocrates gathered his disciples, taught them medicine, and wrote books on the subject. In Japan as well, medicine was introduced from China and other continents in ancient times, and in the Heian period（７９４‐１１８５）, Tamba Yasuyori wrote “Ishinpo”, which was a systematic form of medicine. During the Edo period （１６０３‐１８６８）, people learned medical science through apprenticeship with prominent doctors. From the end of the Edo period to the Meiji era, the Western style of medical schools came in, where several doctors with different educational abilities with different specialties came together to systematically teach medicine to a large number of students.
The ２０th century saw an accelerated fragmentation of medical specialties and an exponential increase in the amount of information about medicine. This trend has continued at an accelerated pace today and will continue for many years to come. On the other hand, the length of medical schooling has remained basically unchanged. It is unlikely to change much in the future ; until the first half of the ２０th century, lectures still seemed to be exhaustive. The lecture notes of medical students at that time tell the story of dictation that rivaled the textbooks of the time ; in the second half of the ２０th century, such exhaustive lectures gradually diminished and the style of teaching began to change. Audio-visual materials were also introduced to increase the amount of information conveyed per credit hour. In addition, bedside teaching was introduced, and clinical practice began to be substantiated.
In the late １９８０s, new educational methods such as the New Pathway at Harvard University in the U. S. were introduced, and in the １９９０s, some universities in Japan began to introduce these methods, which accelerated at the beginning of this century. In the １９９０s, universities began to introduce a new method of teaching, such as the small-group tutorial format, in which learners learn mainly by discussion, and faculty members take the role of supporting them. Students who had been fed cooked medical information through spoon feeds are now required to acquire the ability to prepare and eat the ingredients themselves. We have entered an era in which students are expected to develop the ability to make the best use of the vast amount of medical information that is available. In addition, it is no longer important to assess “how well the faculty taught the students” but rather “how well the students were able to do what they were able to do”. Quality and quantity are now being assessed in clinical practice, and students are now expected to participate in the practice team. It is a deeper, more practical learning（deepening）, a style of learning that would have been done after graduation in the past. And it became common sense to organize the curriculum around a core of what students should have acquired after graduating from medical school（coring）. Seamless connections between undergraduate education and post-graduate clinical training will be even more sought after in the future. They must be connected to specialty training and postgraduate education. The fundamental driving force behind this evolution of medical education has been medical research, which has led to an increase in medical information. There is no doubt about it. With the times, the true value of medical education is being questioned. Ars longa, vita brevis-Hippocrates