TRAINING AND CLINICAL COMPETENCE IN MUSCULOSKELETAL MEDICINE - IDENTIFYING THE PROBLEM

Injuries and diseases of the musculoskeletal system account for more t han 20% of patient visits to primary care and emergency medical practi tioners. However, less than 3% of the preclinical medical school curri culum is devoted to teaching all aspects of musculoskeletal disease, a nd only 12% of medical schools require mandatory training in musculosk eletal medicine during the clinical years of undergraduate medical edu cation in Canada. Available elective training in musculoskeletal injur ies and diseases is commonly taught by hospital-affiliated physicians and surgeons, with the result that this teaching case load is typicall y skewed towards serious and/or surgical problems. The disparity betwe en the clinical competence required for musculoskeletal problems in cl inical practice and the content and format of medical education has no t yet been addressed by changes in medical school curricula. One of th e reasons for this is that the available morbidity statistics, which p rovide data regarding the frequency of specific musculoskeletal diagno ses, are based on diagnostic codes which are imprecise and incomplete. This prohibits the accurate selection of course content in this area, which is among the first steps in the development of a curriculum.