Medical education and chronic disease
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* Anton R. Miller
* Magdalena A. Recsky
* Robert W. Armstrong

*   © 2005 CMA Media Inc. or its licensors

Serge Dubé's comments illustrate an extremely important dimension of the problem of transforming health care services for people with chronic diseases. In our commentary1 we focused on the need for shifts in policy in this area, but we agree that fundamental changes in physician skills, and perhaps attitudes, will also be required for physicians to play an effective role in the continuing care of patients with chronic conditions. Considerable reform of medical education curricula and goals will be required to meet the contemporary challenge of chronic diseases. Dubé alludes to some current deficiencies. In a recent overview of this topic, Holman2 helpfully articulated details of the important role of medical education in this era of chronic disease and suggested specific learning experiences for trainees that should be offered within ambulatory care programs structured around a chronic disease model of care. These ideas could be refined and implemented within Canadian medical residency education to teach students about the types of patients they will frequently encounter over the course of their careers. Furthermore, the topic of caring for patients with chronic disorders could be introduced into longitudinal courses at the undergraduate level, to give students early exposure to the prevalence, importance and unique aspects of this domain of health care.

## References

1.  1. Miller AR, Recsky MA, Armstrong RW. Responding to the needs of children with chronic health conditions in an era of health services reform [editorial]. CMAJ 2004;171(11):1366-7.
    
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2.  2. Holman H. Chronic disease — the need for a new clinical education. JAMA 2004;292(9):1057-9.
    
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