Doctors Without Borders

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Abstract

The unprecedented demands of patient and population priorities created by globalization and escalating health and social inequities will not be met unless medical education changes. Educators have failed to move fast enough to create an education framework that meets current population needs. A new common set of professional values around global social accountability is necessary. Education borders must be broken down at three levels—societal-institutional, interpersonal, and individual.

At a societal-institutional level, global health must be embraced as part of a philosophy of population needs, human rights, equity, and justice. A move from informative acquisition of knowledge and skills to formative learning where students socialize around values, develop leadership attributes, and become agents for change is needed. At an interpersonal level, radical changes in curriculum delivery, which move away from the well-defined borders of specialty rotations, are required. Students must develop an integrated understanding of the future of health care and the patient’s journey through health care delivery, within the context of population needs. At an individual level, doctors need to understand the boundaries of the professional values they hold within themselves and develop a deeper understanding of their own internal prejudices and conflicts. Opening the borders between the sciences and humanities is essential. Fostering and mentoring that emphasize that resilience, leadership, flexibility, and the ability to cope with uncertainty are needed to tackle the complexities of current, as well as future, health care. Doctors need to understand the restraints within themselves to work effectively without borders.

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