Introduction edical education is currently in a state of rapid evolution. The purpose of this paper is to consider some emerging trends in how our future physicians are trained during medical school. The initial four years after completion of the bachelor’s degree, known as undergraduate medical education or UME, serve as the foundation of subsequent lifelong learning. Whether a given medical school has a strong primary care mission or primarily emphasizes the preparation of future academicians, the educational issues prominent today are basically the same: how can we best train the physicians who will likely care for us and our children? The importance of this educational mission and the need to ensure its continued prominence in our society cannot be over-emphasized. There are many categories of educational trends that affect UME, but this paper will address only two. These trends may be classified into two broad categories as follows: Educational Theory and Philosophy; and Medical Professionalism and Humanism. I will speak briefly about each category. Educational Theory and Philosophy At first glance, one may be tempted to think that an emphasis on educational theory and philosophy is nothing different, so how can this be an emerging trend? After all, isn’t education and related theories what a medical school is about? Believe it or not, the answer is “yes and no.” A seasoned medical educator once wrote a tongue-in-cheek editorial entitled “When Is a School Not a School? When It Is a Medical School.” 1 Historically, much of what has passed for formal education in medical schools consisted of activities that appeared to have been given seemingly little advance thought. Part of the reason for this is the long-standing use of the apprenticeship model of education, where students simply followed physicians and learned by observation. Such learning, especially during the clinical years, is highly context-dependent; students learned about patient care based on the types of patients that happened to show up in the hospital or clinic during a given time frame. However, with major recent changes in the healthcare system itself (especially shorter lengths of stay for nearly all patients who are hospitalized), we are now challenged to incorporate as much “real world” training as possible into the medical curriculum. As a result, more and more training is moving out of teaching hospitals and into a variety of new settings. So part of this trend reflects the rapidly changing environment for training medical students and resident physicians. We know from educational research that there are three things that correlate highly with student achievement, regardless of what field of study one is engaged in. Those three things are: clarity of purpose, organization, and understandability. In other words, if you, as a student, know what the purpose of a given course or clerkship is, in terms of educational objectives, if the course or clerkship is organized to maximize your chances of achieving the educational objectives, and if you have a clear understanding of what you are expected to know and do (and how to do it), then chances are you will learn what you are supposed to learn. There is great variability in how medical schools go about planning and carrying out the educational experiences required of medical students. Most medical school faculty members have little, if any, formal training in educational methods. Partly because of this lack of training, educational activities are sometimes highly organized; but at other times, they aren’t. There are many factors that have an impact on how well faculty organize and carry out the educational mission, most notably the increasing time pressures faced by many teaching physicians and the lack of a stable funding source for medical education that takes place outside of the teaching hospital itself. Nevertheless, as stated in a recent journal article on residency training (i.e., graduate medical education), the emerging trend today is to “put the E back in medical education.” 2 Specifically, a major emphasis that has surfaced in recent years is the “outcomes movement.” This concept requires educators to pay increased attention to not only the process of education (i.e., how we teach), but also to the outcomes of the process (i.e., whether students actually learned what we claim to have taught them). An illustration might help here. There once was a small 244 NC Med J May/June 2005, Volume 66, Number 3 Emerging Trends in Medical Education: What Are They? And Why Are They Important? David W. Musick, PhD SPECIAL ARTICLE David W. Musick, PhD, is Associate Dean of Medical Education at the Brody School of Medicine at East Carolina University. He can be reached at musickd@mail.ecu.edu or 600 Moye Blvd, Brody 2N-72D, Greenville, NC 27834.Telephone: 252-744-2132. M