Medical Teacher, Vol. 27, No. 8, 2005, pp. 686–692

An update on master’s degrees in medical

RICHARD COHEN, LUCAS MURNAGHAN, JOHN COLLINS & DAN PRATT Department of Educational Studies, Faculty of Education, of British Columbia, Vancouver,

SUMMARY Planning and implementing educational programs Steinert et al. (2003) reported on a one-year faculty in optimally requires a background in educational theory development program offered by the medical education and practice. An avenue of training open to such practitioners is a department at McGill University aimed at increasing skills master’s degree in medical education. A single 1998 report lists the in teaching, administration and and programs known at that time and information about them leadership. A one-year post-completion survey showed that remains scarce. The authors have re-examined all current many faculty members had joined new educational commit- programs offering master’s degrees in medical or health sciences tees, taken on new leadership roles in medical education, education in the English-speaking world, including the and developed new courses for students and residents. Netherlands. The authors contacted the programs identified in Likewise, Gruppen et al. (2003) at the University of the 1998 report to establish how many were still in operation. The Michigan reported on a program with similar objectives and search was extended using Pubmed and other search engines. outcomes. Paloli et al. (2003) demonstrated that even short- A further verification targeted a selected sample of 10 prominent term programs combined with proper needs assessments US medical schools. Twenty-one currently operating programs can provide practical and theoretical foundations for were identified: six in the US, eight in the UK, three in Canada, developing educational skills. three in Australia and one in Holland. Seven of nine original What of those individuals who require a deeper under- master’s programs were still in existence. URLs, website and other standing of educational theory, research and practice, either logistical information about each program are tabled. A master’s in the hope of assuming leadership roles in educational degree in medical or health sciences education is the most specific development and administration of medical schools, or method for medical faculty to obtain a credentialed grounding in for their academic ends alone? Scho¨n (1995) has pointed educational theory and practice. The authors provide up-to-date out that scholarship which goes beyond telling practitioners contact information for current programs and summarize other ‘how’ requires a new epistemology, one that examines the related essential logistical data. theoretical foundations and rationale behind educational For personal use only. practices and which focuses on the philosophical justification of the specific outcomes sought in medical education. Schools of education commonly have departments of Introduction studies giving instruction in specific areas, but Educating medical students and residents is a complicated these are usually aimed at the elementary or secondary and time-consuming process. Prospective must educational levels. Further study in is also an acquire a large body of knowledge and incorporate it into a option but the field is vast, and in most departments is usually working framework of clinical reasoning that in turn informs directed toward the social sciences. The unique demands of effective medical practice. The skills, techniques and mind- medicine require the depth and breadth of a master’s degree specific to medical (or health professions) education—a Med Teach Downloaded from informahealthcare.com by McMaster University on 12/01/10 sets which medical instructors must possess in order to cultivate the transformation of students into physicians do training platform aimed at a higher level than those provided not arise automatically, nor are they inborn. by most faculty development, certificate or diploma pro- There is an increasing appreciation of the contributions grams. Cusimano and David (1998) reported on existing opportunities in health professions education and identified of educational research and theory as valuable resources 15 programs. There are critical access problems for anyone in developing and delivering effective medical training seeking information on such programs, however. Although (Whitcomb, 2003). Specialists who focus their academic their article has been available for seven years, it has only work and research on educational issues need appropriate been cited twice elsewhere in the literature, and on both academic training in educational theory and practice in order occasions by the same author (Steinert, 2000; Steinert et al., to make significant contributions to understanding and 2003). Thus we had three objectives in conducting this study: improving ‘what works’ in medical education. first, to re-examine Cusimano and David’s data to see which Various avenues are open to physicians or other of those programs still existed; second, to identify any new healthcare professionals and educators who wish to enhance programs that had been established in the interim; and third, their skills in educational theory and research in medical to summarize the information available on these programs’ education contexts. Many faculty development programs are websites for the medical community at large. operated by medical schools themselves. These programs extend anywhere from a single lecture to a single day, to a Correspondence: Dr Dan Pratt, Department of Educational Studies, Faculty of year or two in length, and all aim to increase the academic Education, University of British Columbia, 2125 Main Mall, Vancouver, expertise of their participants. BC, V6T 1Z4, Canada. Email: [email protected]

686 ISSN 0142-159X print/ISSN 1466-187X online/05/080686–7 ß 2005 Taylor & Francis DOI: 10.1080/01421590500315170 Table 1. Data summary for the twenty-one programs.

Geographic Academic Program Program Institution location location Degree title Certificate Diploma Website Contact name Contact email director Duration delivery

CANADA University of Toronto Toronto, ON, Faculty of Master’s of No No http://www.oise.utoronto.ca/ Dr. Daniel Lang dan.lang@ Dr. Daniel Lang, 3 years Both (Ontario Institute for Canada Education Education depts/tps/program_he_ utoronto.ca PhD Studies in Education) (OISE) (Health masters.html Professions Specialization)

Dalhousie University Halifax, NS, Department of Masters of Education/ No No http://facdev.medicine.dal.ca/ Cynthia Mantley Cynthia.Mantley@ Dr. Fred French, 2–3 years Both and Mount Saint Canada Education Master of Arts degree.htm msvu.ca PhD Vincent University (Mount Saint in Education with Vincent a Conc. In Med Ed University)

University of Calgary Calgary, AB, Faculty of Masters of Science No No http://gse.myweb.med.ucalgary.ca/ Kate Judycki mededgrd@ Dr. Claudio Violato, 2–7 years Face to Face Canada Medicine in Medical MedicalEducation.html ucalgary.ca PhD Education University of Illinois Chicago, College of Masters of No No www.uic.edu/com/mcme/ Janet Settle [email protected] Dr. Ilene Harris 2–3 years Both at Chicago Illinois, Medicine Health Professions mhpeweb/Home.html USA Education For personal use only. For personal (MHPE) University of Pittsburgh, School of Masters in Yes No www.crhc.pitt.edu/cetp/ Claudia Brink [email protected] Dr. Rosanne Granieri, 2–3 years Face to Face Pittsburgh Pensylvannia, Medicine Medical MD USA Education University of Los Angeles, Faculty of Masters of No No http://mededonline.hsc.usc.edu/ Cris Argosino argosino@ Ms. Diane 2 years Both Southern California California, Medicine Science in msedprog.html usc.edu Boughton, MSEd (Keck School of USA Education Medicine)

University of Cincinnati, College of Online Masters Yes Yes www.cincinnatichildrens.org/ Lea Alaee lea.alaee@ Dr. Kadriye Lewis, 2 years Online only education medical in degrees Master’s Cincinnati Ohio, Education Degree in ed/clinical/grad/masters/ cchmc.org EdD USA Education default.htm Loma Linda University Loma Linda, Faculty of Master of Science Yes No www.llu.edu/llu/grad/ Lisa M. Beardsley, lbeardsley@ Dr. Billy Hughes, Not Not

Med Teach Downloaded from informahealthcare.com by McMaster University on 12/01/10 University by McMaster from informahealthcare.com Teach Downloaded Med (Graduate School) California, Medicine healthprofessions/ PhD, MPH llu.edu PhD Specified Specified USA Vice Chancellor, [email protected] Academic Affairs University of Ann Arbor, School of Masters of Education No Yes http://www.soe.umich.edu/ Larry Gruppen lgruppen@ Dr. Patricia King, 2 years Both Michigan Michigan, Education with a Concentration highereducation/overview/ umich.edu PhD USA in Medical Education index.html 687 .Cohen R. 688 tal. et UNITED KINGDOM University of Sheffield, Faculty of Masters in Yes Yes http://www.shef.ac.uk/%7edme/ Gail Hible g.hible@ Dr. Patsy Stark, 3 years Both Sheffield England Medicine Medical Education courses/masters.htm sheffield.ac.uk PhD (Academic Unit of Medical Education) University of Dundee Dundee, Faculty of Masters in Yes Yes www.dundee.ac.uk/prospectus/ Margaret Christie c.m.e.courses@ Dr. Margery H. Davis 1–6 years Both Scotland Medicine, Medical Education graduate/profiles/meded.html dundee.ac.uk and Cardiff Cardiff, Faculty of Masters of Science No Yes http://www.uwcm.ac.uk/study/ Zara Evans [email protected] Prof. T.M. Hayes, 2–3 years Face to Face Wales Medicine in Medical postgraduate/medical_education/ FRCP Education index.htm University of Bristol Bristol, Faculty of Masters in Yes Yes http://www.bris.ac.uk/fmd/ Marcia Dring tlhp-enquire@ Dr. Stephen Greenwood 3–8 years Both England Medicine Medical Education gradschool/courses/tlhp bristol.ac.uk EdD and Dentistry Queen’s University Belfast, Faculty of Master of Medical Yes Yes http://www.qub.ac.uk/cm/me/ Mairead Boohan m.boohan@ Ms. Mairead Boohan 2 years Face to Face at Belfast Northern Medicine Science in msc-handbook.pdf qub.ac.uk Ireland Education for the Professions Keele University Stoke-On-Trent, School of Medicine Masters of Yes Yes http://www.keele.ac.uk/depts/aa/ Pam Stone p.stone@ Dr. Vincent Cooper 3 years Both England Medical Education postgraduate/studyguide/pdfs/ keele.ac.uk Health/medicaleducationsmall.pdf University of Newcastle, Faculty of Masters of Yes Yes www.ncl.ac.uk/postgraduate/taught/ Ms Marian Beavis marian.beavis@ Dr. Gabrielle Greveson, 3–6 years Both Newcastle England Health Sciences Clinical Education subjects/taught-bbsmd/courses/36 newcastle.ac.uk MD, EdD (Upon Tyne) (School of Medical Education For personal use only. For personal Development) University of Nottingham, Faculty of Masters of Medical Yes Yes http://www.nottingham.ac.uk/ Trina Medlicott trina.medlicott@ Dr. Reg Dennick 2 years Face to Face Nottingham England Health Sciences/ Science in mczchs/pg/prospectus/clined/ nottingham.ac.uk School of Clinical Education Community Health Sciences AUSTRALIA University of Sydney Sydney, NSW, Faculty of Masters of Yes Yes http://www.dme.med.usyd.edu.au/ Cheryl cherylhs@ Dr. Greg Ryan, 2–5 years Both Australia Medicine Medical Education mmeded/index.html Henderson-Smart med.usyd.edu.au PhD University of Sydney, NSW, Facutly of Masters of Yes Yes http://www.handbook.unsw.edu.au/ Ms Karin Banna k.banna@ Not Specified 2 years Both New South Wales Australia Medicine Clinical Education postgraduate/programs/2005/ unsw.edu.au 9050.html

Med Teach Downloaded from informahealthcare.com by McMaster University on 12/01/10 University by McMaster from informahealthcare.com Teach Downloaded Med Flinders University Adelaide, Faculty of Masters in Yes Yes http://som.flinders.edu.au/FUSA/ Dr. Jennene Greenhill Clinical. Dr. Jennene Greenhill 2 years Both South Australia Medicine Clinical Education GP-Evidence/rural/education/ Education@ PhD postgrad/clinicaled/index.htm flinders.ac.au NETHERLANDS Maastricht Universtiy Maastricht, Faculty of Masters of Health No No www.mhpe.unimaas.nl/ Caroline Steeghs, mhpe@ Dr. Jan van Dalen, 2 years Both Netherlands Health Sciences Professions general_information.html Tanja van Zoeren educ.unimaas.nl PhD Education (MHPE) Master’s degrees in medical education

Methods clearly interested in such a directory, none of these organizations was able to provide additional information. Cusimano and David’s paper provided an initial As a further check on our initial findings, we contacted ‘compendium’ of opportunities in health a sample of 10 prominent medical schools in the USA that professions education. However, our inclusion and exclusion were not in our initial data set. We received replies from nine criteria differ from their original paper. Our database was of them, but identified only one new master’s degree program restricted to programs that offered a master’s degree at in medical education, at the University of Michigan. Further, completion, and we focused exclusively on advanced we initiated direct electronic communication with all educational training in medicine or the healthcare profes- institutions where there was a previous report (or hint by sions. We excluded all programs that led only to diplomas, expert opinion) of an existing program. This further certificates or attendance acknowledgements irrespective of expanded our own inventory to its current total of 21 master’s their length, although many master’s programs offered degree programs. credentialed modules on the way to completion of a master’s From this information, we generated a database degree. As well, we excluded PhD programs based on containing the following 12 fields: name of institution, two assumptions. First, that people involved in medical geographic location, academic location, title of the degree, (or health) education have limited time to commit to whether intermediate certificates or diplomas were offered, additional formal training. Whether they are full-time faculty website URL, the program’s contact name and email, or students taking time out of programs, they must the program director’s name, the anticipated duration of subtract time from other responsibilities to engage in further study, and finally whether the program was offered online, medical or training. Because PhD programs face-to-face, or some combination of the two. Any informa- require several years to complete and often require a year or tion not specified on the school’s website was sought directly more of full-time commitment, such programs may exceed from the program. Program information was emailed to the time available. Second, that people involved in medical each program’s director for verification with an invitation to or health education seek further training in order to make correct any errors. Simultaneously, program directors were more informed contributions to medical or health education informed of our intentions to compile their data along with practice rather than establishing careers as researchers in that of other programs and to publish our findings. medical education. For the most part, PhD programs are intended to train researchers while master’s programs focus on practitioners; thus we assumed that master’s Results programs would be more in line with current trends. Table 1 summarizes the data from these 21 programs on Therefore, because most PhD programs require greater three continents. We first explain each field, then briefly time commitment, emphasize original research and aim to discuss our findings. prepare people for research-based careers, we excluded them

For personal use only. from our inventory. An initial index search yielded two sources that Geography had referenced Cusimano and David’s compendium, both by the same author (Steinert, 2000; Steinert et al., 2003). These The programs are first grouped by country, then further papers discussed the importance of faculty development located by city or region within each country in the programs in medical education. A Medline search on the ‘geographic location’ field. We identified three programs same topic yielded only a single paper that was chiefly in Canada, six in the United States, eight in the United concerned with master’s degrees in the general field of Kingdom (five in England, and one in each of Wales, education (Burton, 2000). Though this paper discussed Scotland and Northern Ireland), three in Australia, and one master’s degrees in medical education, it was not specific to in the Netherlands.

Med Teach Downloaded from informahealthcare.com by McMaster University on 12/01/10 this topic. We expanded our search by using a variety of public search engines (Google, Yahoo, Alta Vista) and Academic location of program web-based information provided by individual medical schools. We constructed the search using a variety of search The majority of programs were located in the institution’s phrases including: ‘master’s of/in medical education’, ‘grad- faculty/school/college of medicine, or in a school of medical/ uate degree in medical education’, ‘master’s of health health sciences (the institutional labels for these academic professions education’, or ‘master’s of clinical education’, units varies considerably). Two programs granted their among others. These searches resulted in a number of master’s degrees from the departments of education at their retrievals that we explored to determine their suitability for institutions. In the case of Canada’s Dalhousie University, inclusion. the master’s degree was awarded by a neighboring insti- To further enrich the scope of our search, we tution’s Faculty of Education—Mount Saint Vincent’s communicated directly with a number of organizations to University. enquire about their knowledge of existing directories— complete or otherwise—including the Association of Degree title American Medical Colleges (AAMC), the Association of Faculties of Medicine in Canada (AFMC), the Association There was a range of nomenclature of the various programs. for the Study of Medical Education (ASME), the Association Most were labeled some variation of ‘Master’s of Medical for Surgical Education (ASE), and the Association for Education’. A minority made explicit reference to all health Medical Education in Europe (AMEE). Though they were professions in their title, for example, ‘Master’s of Health

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Professions Education’ (MHPE) at the University of Illinois education, ethics and multicultural education. Some pro- at Chicago, at the University of New South Wales, and grams also required students to complete a teaching at Maastricht in the Netherlands. Degrees located in practicum. Because of the irregularity and inconsistency schools of education were generally designated as ‘Master’s of these data, we chose not to include this information in of Education’ (MEd) with a specialization/concentration in Table 1. the health professions.

Discussion Certificates/diplomas We have identified 21 currently operating programs offering Twelve master’s degree programs offered intermediate master’s degrees in medical education—a more than twofold certificates and 10 programs offered intermediate diplomas. increase. Cusimano and David (1998) found nine programs Some schools offered one but not both of these intermediate that offered master’s degrees in medical education that qualifications. matched our inclusion criteria. We excluded three of their programs: two based on content and a third based on target Website audience. The program offered by Baylor College is limited exclusively to dentists. The University of Toronto Family We verified each individual program’s URL as of 26 October and Community Medicine program is focused more broadly 2005. In doing so, we strove to provide accurate, up-to-date, on community practice rather than medical education. The and direct access to each program. University of Washington program focuses on medical informatics as opposed to medical education. In our current search, we could locate only seven of their nine master’s-level Contact information programs, thus raising the question of what happened to the The name and electronic mail address of each program’s remaining two—particularly in view of the relatively few such contact individual is listed, as is its program director. In a initiatives worldwide. It would be interesting to follow them few cases, these are the same person, but for the majority of up and inquire about the reasons for their disappearance in programs, contact persons and program directors are the hope that new offerings might avoid any identifiable different people with different addresses. mistakes. A principal change since the original Cusimano and David paper is the proliferation of the Internet, which has Duration made the dissemination of program information much easier. The allowable time to complete these programs ranged Most programs have websites, which vary as to ease of use from one to eight years. This information was obtained from and completeness of information. During our search, it was the program website or program director and indicates not possible to verify how up to date each website was. These For personal use only. the minimum and maximum time allocated for degree caveats must be considered when interpreting the course completion in each program, not the average time taken. topic data. What was clear was the variation in responsiveness from program directors or contact persons; some replied within the same day while others replied only after prolonged Program delivery periods or not at all. We trust that this report challenges Fourteen programs offered a program delivery structure program administrators to update their websites regularly, that combined ‘face-to-face’ requirements together with and to respond accurately and promptly to all queries. certain distance learning components. Most distance Websites serve as vital interfaces between programs and learning was offered online, but some programs still use students, but any program’s intrinsic worth is damaged by

Med Teach Downloaded from informahealthcare.com by McMaster University on 12/01/10 correspondence-by-mail. Five programs (the weak information, poor communication or sluggish of Calgary, Pittsburgh, Cardiff, Nottingham and Belfast) responsiveness. offered only ‘face-to-face’ instruction, while one program (the University of Cincinnati) offered their entire curriculum Geographic concentration exclusively online. The geographic distribution of these programs is striking. We were able to identify only six programs throughout Content the USA—a surprisingly small number given the country’s Course topics were displayed with varying degrees of population and its 126 medical schools (Association of detail on the websites of the 18 programs that had them. American Medical Colleges, 2004). The UK currently A majority of the programs offered courses in quantitative offers eight programs with only 28 medical schools and qualitative research, learning theory, clinical teaching (Institute for International Medical Education, 2004). and problem-based learning, written and clinical assessment, Likewise, the ratio of master’s programs to medical schools curriculum management, program evaluation and teaching is significantly higher for Canada, Australia and Holland than skills. Many programs also required a research-based thesis. for the United States. A minority of programs offered courses on topics such as The striking variation in ratios of medical education critical thinking and medical decision-making, basic science degree programs to medical schools or national populations teaching, resident teaching, continuing medical education, is all the more surprising considering the increased stature faculty development, the role of technology in medical of educational research and development in medical schools

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more generally. Many universities, including our own individuals who graduate with higher training in medical institution, now formally recognize the scholarship of education (Gruppen et al., 2003; Steinert et al., 2003). It teaching and educational research as criteria for promotion might be worthwhile examining these careers in greater detail and tenure (Boyer, 1990). Similarly, there are also educa- to determine whether faculty possessing these further tional residency options under development in orthopedics, qualifications can be shown to influence the educational family and community medicine, and outcomes at their respective institutions. that recognize and support extended study in In summary, we have described master’s degree medical education through our university’s Department of programs in medical education, provided links to their Educational Studies. If our university is at all typical, we relevant websites, emphasized the importance of maintaining might assume an increasing demand for advanced study in an up-to-date database for interested individuals, and medical education that includes not only practice- discussed avenues for future research. We have made no based content but explicit training in the theoretical and attempt here to judge individual programs or to supply philosophical foundations of medical education. detailed information on the nature or quality of their courses’ As well, Whitcomb (2002, 2003) has recently encour- content. However, the information provided will enable aged initiatives that lead to large-scale results-oriented interested individuals to pursue further information on which research in medical education and has emphasized the to base their own opinions. We trust that this paper serves as importance of faculty in the educational life of the medical a reminder to the medical education community to school. Both of these measures would be facilitated by wider strengthen its efforts and interests in an area vital to the availability of graduate training in medical education. There continuing educational development and renewal of the is an evident and emerging need for further study and profession. expertise that is not available through certificates, diplomas or faculty development initiatives. The increase in numbers Practice points and availability of master’s degree programs may be a response to this growing need. . A master’s degree in medical or health sciences Need for a centralized and timely database education provides essential grounding in educational theory and practice for health science educators. At times, it was challenging to locate and confirm informa- . An original 1998 study identified all programs offering tion about these various master’s degree programs. None master’s degrees in medical education. of the major organizations monitoring medical education in . We have significantly updated this information sub- Europe and North America had any centralized information sequent to the widespread use of the Internet. regarding these programs, thus making it difficult for any . We provide suggestions for future research in the field.

For personal use only. individual wanting to identify or enroll in such a program and discouraging anyone wishing to expand a career choice into medical education. This moment may be a good opportunity for organizations such as the AAMC, ASME or AMEE, Notes on contributors or alternatively the World Federation for Medical Education, RICHARD COHEN, MBChB FRCPC, is a Clinical Assistant Professor, to launch and maintain such a database. Once sufficient Department of Medicine, University of British Columbia. momentum is gathered and schools become aware of the LUCAS MURNAGHAN, MD, is a resident in the Department of database, it becomes relatively simple for new programs to Orthopaedics at the University of British Columbia. submit their data and for existing programs to update their JOHN COLLINS, PhD, is an Adjunct Professor in the Department of own information. Failing any central coordination, it will be Educational Studies at the University of British Columbia.

Med Teach Downloaded from informahealthcare.com by McMaster University on 12/01/10 up to individual researchers to address these questions DAN PRATT, PhD, is a Professor in the Department of Educational periodically and to disseminate the information—a less Studies at the University of British Columbia. productive strategy in the long term. Our paper has at least two limitations that we must acknowledge. First, although we used multiple methods to References verify and extend our search, we may still have missed some programs. We apologize to any programs that have ASSOCIATION OF AMERICAN MEDICAL COLLEGES (2004) Website. inadvertently been omitted or for any information that is Available at: http://www.aamc.org/medicalschools BOYER, E.L. (1990) Scholarship Reconsidered: Priorities of the incorrect. Correcting such errors is certainly more easily Professoriate (Princeton, NJ: Carnegie Foundation for the handled through a centralized database. Second, our search Advancement of Teaching). covered only the English-speaking world (plus the Maastricht BURTON, J.L. (2000) Get a master’s degree in education (BMJ Careers) program in the Netherlands). There are very probably (London: BMJ Publishing Group). excellent programs in non-English-speaking countries as CUSIMANO, M.D. & DAVID, M.A. (1998) A compendium of higher well. education opportunities in health professions education, Academic Our research invites further questions concerning the Medicine, 73, pp. 1255–1259. GRUPPEN, L.D., FROHNA, A.Z., ANDERSON, R.M. & LOWE, K.D. (2003) quality of each program in addition to questions concerning Faculty development for and scholarship, their theoretical, philosophical and conceptual bases. Academic Medicine, 78, pp. 37–141. These issues must be left for future studies. Previous papers INSTITUTE FOR INTERNATIONAL MEDICAL EDUCATION (2004) Website. have described qualitative changes in the careers of Available at: http://www.iime.org/database/europe/uk.htm.

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PALOLI, L.H., DENNIS, K., WINN, G.M. & MITCHELL, J. (2003) A needs STEINERT, Y., NASMITH, L., MCLEOD, P.J. & CONOCHIE, L. (2003) A assessment of faculty: caring for the caretakers, teaching scholars program to develop leaders in medical education, Journal of in the Health Professions,23, Academic Medicine, 78, pp. 142–149. pp. 21–29. WHITCOMB, M.E. (2002) Research in medical education: what do we SCHO¨ N, D.A. (1995) The new scholarship requires a new epistemology, know about the link between what doctors are taught and what they do?, Change, November/December, pp. 27–34. Academic Medicine, 77, pp. 1067–1068. STEINERT, Y. (2000) Faculty development in the new millennium: key WHITCOMB, M.E. (2003) The medical school’s faculty is its most challenges and new directions, Medical Teacher, 22, pp. 44–50. important asset, Academic Medicine, 78, pp. 117–118. For personal use only. Med Teach Downloaded from informahealthcare.com by McMaster University on 12/01/10

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