The future of medical education is no longer blood and guts, it is bits and bytes

In the United States, medical care consumes approximately $1.2 trillion ann ually (14% of the gross domestic product) and involves 250,000 physicians, almost 1 million nurses, and countless other providers. While the Informati on Age has changed virtually every other facet of our life, the education o f these healthcare professionals, both present and future, is largely mired in the 100-year-old apprenticeship model best exemplified by the phase "se e one, do one, teach one." Continuing medical education is even less advanc ed. While the half-life of medical information is less than 5 years, the av erage physician practices 30 years and the average nurse 40 years. Moreover , as medical care has become increasingly complex, medical error has become a substantial problem. The current convulsive climate in academic health c enters provides an opportunity to rethink the way medical education is deli vered across a continuum of professional lifetimes. If this is well execute d, it will truly make medical education better, safer, and cheaper, and pro vide real benefits to patient care, with instantaneous access to learning m odules. At the Center for Advanced Technology in Surgery at Stanford we env ision this future: within the next 10 years we will select, train, credenti al, remediate, and recredential physicians and surgeons using simulation, v irtual reality, and Web-based electronic learning. Future physicians will b e able to rehearse an operation on a projectable palpable hologram derived from patient-specific data, and deliver the data set of that operation with robotic assistance the next day. Am J Surg. 2000;180:353-356. (C) 2000 by Excerpta Medica, Inc.