Noteworthy changes coming to the practice of medicine require significant medical education reforms. While proposals for such reforms abound, they are insufficient because they do not adequately address the most fundamental change-the practice of medicine is rapidly transitioning from the information age to the age of artificial intelligence. Increasingly, future medical practice will be characterized by: the delivery of care wherever the patient happens to be; the provision of care by newly constituted health care teams; the use of a growing array of data from multiple sources and artificial intelligence applications; and the skillful management of the interface between medicine and machines. To be effective in this environment, physicians must work at the top of their license, have knowledge spanning the health professions and care continuum, effectively leverage data platforms, focus on analyzing outcomes and improving performance, and communicate the meaning of the probabilities generated by massive amounts of data to patients, given their unique human complexities. The authors believe that a "reboot" of medical education is required that makes better use of the findings of cognitive psychology and pays more attention to the alignment of humans and machines in education and practice. Medical education needs to move beyond the foundational biomedical and clinical sciences. Systematic curricular attention must focus on the organization of professional effort among health professionals, the use of intelligence tools involving large data sets, and machine learning and robots, all the while assuring the mastery of compassionate care.
Available medical knowledge exceeds the organizing capacity of the human mind, yet medical education remains based on information acquisition and application. Complicating this information overload crisis among learners is the fact that physicians' skill sets now must include collaborating with and managing artificial intelligence (AI) applications that aggregate big data, generate diagnostic and treatment recommendations, and assign confidence ratings to those recommendations. Thus, an overhaul of medical school curricula is due and should focus on knowledge management (rather than information acquisition), effective use of AI, improved communication, and empathy cultivation. Natural illnesses are cured, but never those which medicine creates, for it knows not the secret of their cure. Marcel Proust 1 Information Overload The system for educating medical students is approaching a crisis driven by 2 compelling forces: growing externalization of available medical knowledge outside the minds of physicians and stress-induced mental illness among learners. 2-5 Classically, a physician is defined as a professional who possesses special knowledge and skills derived from rigorous education, training, and experience, 6 but the amount of available medical knowledge now exceeds the organizing capacity of the human mind. 7 What's known colloquially as "information overload" is caused not only by the volume of biomedical and clinical knowledge, but also by the rapidity of its increase and pressures on learners to achieve board scores high enough on the 3 United States Medical Licensing Examinations ® to be chosen for competitive residency positions. 4,8 Medical practice today requires both high productivity and delivering on expectations for health outcomes-demands that can negatively impact learners' mental health.
The location patterns of young physicians who settled in the most rural communities of America between 1973 and 1976 are analyzed. The majority of these recent rural settlers were primary care practitioners. They tended to be the alumni of state university medical schools in states with large rural populations. Foreign medical graduates were heavily represented. The principal finding-a tendency toward further concentration of rural physicians within existing medical communities-suggests that those rural communities with the greatest needs amy remain underserved without the assistance of organized external programs.
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