Undergraduate medical education. Improve teaching of practical skills.

become the overriding aim of medical education, but it must recognise that some students will seek a medical degree as entry to a variety of activities related to health, including research, education, business, and public service.In such a future how will we define core and protect students' opportunity to exercise independent thought in approaching the complexities of medicine?A core of essential knowledge and skills relevant to medical practice undoubtedly exists and can be identified, but at what cost and to what purpose?In my view, which is coloured by my recent experience as dean of health sciences at McMaster University, medical schools should have confidence in students' ability to discern appropriate learning objectives and to pursue these in a self directed fashion.Judgment of students' qualification for licensure should be separated as much as possible from assessment of academic performance so as to maximise opportunities for personal and intellectual development during medical education.Endorsement of the core and options model without strict limitations on the definition of core will perpetuate a content driven, professorially controlled system of medical education unworthy of Britain's earlier traditions of leadership.The times demand a more aggressive commitment to innovation in the interests of both the public and the profession.