The many and conflicting histories of medical education in Canada and the USA: an introduction to the paradigm wars

BACKGROUND: Medical education research is a maturing field of inquiry that derives theoretical perspectives from many domains. Yet while such theoretical diversity holds the promise of rich paradigmatic writing and debate, too often medical education researchers do not place their work in a historical or cultural context, giving the impression that they have somehow unearthed universal 'truths' about medical education. METHODS: This paper introduces some of the key 'histories' of medical education from the contexts of Anglophone Canada and the USA following a review of major works in the history of medical education. RESULTS: There are many and conflicting histories of medical education in North America that can be classified according to different socio-historical paradigms. CONCLUSIONS: To avoid the error of over-generalisation, a much greater effort must be made to include historical, sociological, economic and other social science perspectives in the design, interpretation and application of medical education research.