ABSTRACT
Many of the problems in graduate medical education (GME) can and should be addressed at the departmental or institutional level. Others will require support from national organizations and legislative bodies. What follows is a list of specific suggestions for change, with the rationale for each. Medical education has stressed the acquisition of scientific and technical knowledge, but given insufficient attention to the humanistic and cultural values that should determine its use. Premedical education should be reconfigured to produce a better balance between the physical and social sciences and the liberal arts to enhance responsiveness to issues of cultural and social diversity that students, residents, and practitioners encounter on a daily basis. Institutions and programs should make clear to residents their obligation to teach students and more junior residents. Judgments by experienced professionals are often the best source of information for performance evaluation, especially in the affective domain.
