Happily, in discussion of the issues in graduate medical education, I was not asked to suggest the resolution of these issues nor the solution of these problems. Therefore, I shall simply delineate issues and identify problems and take the liberty of expressing my personal opinion about their relative importance. I shall confine the discussion to five issues which I believe to be of paramount importance, in my layman's view, and must be faced and resolved most promptly. These issues are (1) discontinuity in the educational process, (2) the persistence of the apprenticeship in the process of education and training, (3) the ineffectiveness and inadequacy in the organization in our present institutions of medical education, (4) the failure to clearly decide on the role of the university in graduate medical education, and (5) the present unsatisfactory balance between generalization and specialization. Discontinuity The process of educating and training the future physician
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John S. Millis (1966) studied this question.