Past and future of emergency medicine education and training
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Abstract: Doctors and other health professionals have been providing care for acutely unwell patients since ancient times. The science and art of clinical practice has predominantly been learned through apprenticeship. The ‘codification’ of medical knowledge for educational purpose started when medical schools first appeared in Italy in the 12th and 13th centuries at Salerno, Bologna and Padua. Although a ‘curriculum review’ is described at the University of Bologna in the late 16th century,3 learning at these institutions was largely confined to the observation of natural history of disease and from autopsies, as effective treatments were few. Approaches to undergraduate medical education in the USA were shaped by the Flexner reforms in the early 20th century and were largely responsible for the current structure of most Western medical schools, with preclinical learning phases followed by apprenticeship based clinical rotations. ‘Emergency medicine’ does not appear as a distinct curricular area within these medical schools, which were generally structured according to the pathological basis of disease.
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