The medical school without walls: Reflections on the future of medical education

Abstract

Introduction: Poems, medical schools and the future of medical education: “Something there is,” Robert Frost said, “that does not love a wall” (Frost 1949). The American poet was providing a lesson: human beings try to build walls; nature attempts to tear them down. Medical educators build walls too: impermeable boundaries between undergraduate and postgraduate education; barriers between health professions; silos created by distinguishing classrooms (and learning) from clinical settings and care; faculties of medicine with no meaningful presence in continuing professional development (CPD). In this commentary, the subject of walls, or the need to tear them down, has been inspired by this question: “If you were made dean of a brand new medical school, with unlimited resources, what would you create?” I feel privileged to write a response to the question, much as I feel privileged to have worked in medical education for nearly five decades, as learner and teacher, fan and critic. In particular, I’m guided by my perspective from the end of the educational continuum: CPD allows a window on the quality, training, experience and outcomes of the educational mills that produce clinicians. It’s led to the creation, in my mind, of an imaginary future school, the medical school without walls. The reasoning that links the concept of walls, the future of medical education, and the question will become clear, hopefully, by the commentary’s conclusion.