Students are not customers: A better model for medical education

The author argues that the student-as customer model of medical education h as many failings that result in interactions that are educationally dysfunc tional. Ten "pathologies" resulting from the adoption of this model are pre sented (e.g., "The student-customer model se duces students into believing that they know what is best: for them"). Part of the reason for the unprofe ssional conduct often demonstrated by students and faculty alike may be a r esult of the influence of this model on medical education and the consequen t inappropriate empowerment of students in the role of customers, the dimin ishment of faculty in the role of workers who provide instruction, and the view that instruction is the service or product of medical education. The author proposes a new model of medical education in which faculty are m anagers of instruction, students are learning workers, the product is succe ssful Learning, and the customers are faculty, residency supervisors, patie nts, managed care organizations, and society. The implications of this new model are profound and are described in terms of Deming's 14 principles for achieving quality in business. The author maintains that the proposed mode l is the critical first step in clarifying and identifying the proper roles of all those involved in the medical education process, which in turn will diminish or eliminate the pathologies that currently plague medical educat ion and lead to the achievement of real duality.