The explosive growth of the professorate, which consists of more than seventy thousand positions, or more than one faculty member per medical student, reflects another striking structural change. Many medical schools introduced a number of lectures and small-group discussions focusing on ethical issues in medical decision making. These innovations are of sufficiently date that in-depth evaluations would be premature. Students can effectively engage in self-study, however, only if medical schools cut back their conventional programs with their many corresponding requirements, thereby enabling every medical student to have significant blocks of uncommitted time to use according to his or her own lights. The preoccupation of the reformers with altering the four-year curriculum of the medical school is understandable. Improving the preparation of medical students for a more effective practice of medicine involves more than a rebalancing of medical school disciplines, important as this may be. The reformers appear to pay little attention to the economics of medical educational innovation.