Elsevier

The Lancet

Volume 376, Issue 9756, 4–10 December 2010, Pages 1923-1958
The Lancet

The Lancet Commissions
Health professionals for a new century: transforming education to strengthen health systems in an interdependent world

https://doi.org/10.1016/S0140-6736(10)61854-5Get rights and content

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Problem statement

100 years ago, a series of studies about the education of health professionals, led by the 1910 Flexner report, sparked groundbreaking reforms. Through integration of modern science into the curricula at university-based schools, the reforms equipped health professionals with the knowledge that contributed to the doubling of life span during the 20th century.

By the beginning of the 21st century, however, all is not well. Glaring gaps and inequities in health persist both within and between

Complex challenges

Health is all about people. Beyond the glittering surface of modern technology, the core space of every health system is occupied by the unique encounter between one set of people who need services and another who have been entrusted to deliver them. This trust is earned through a special blend of technical competence and service orientation, steered by ethical commitment and social accountability, which forms the essence of professional work. Developing such a blend requires a lengthy period

Section 2: major findings

The Commission's major findings are presented in four subsections. The first describes a century of educational reforms, grouped into three generations. The next two subsections present our diagnosis based on the major categories of the conceptual framework. Analysis of institutional design relies mainly on quantitative data to present a global analysis of institutions, graduates, and financing, followed by key stewardship functions such as accreditation, academic systems, faculty development,

Section 3: reforms for a second century

Health is about people; thus, the core driving purpose of professional education must be to enhance the performance of health systems for meeting the needs of patients and populations in an equitable and efficient manner. Our Commission concluded that institutional and instructional shortcomings are leading to shortages, imbalances, and maldistribution of health professionals, both within and across countries. Institutions are not well aligned with burdens of disease or the requirements of

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