Sweeping reforms recommended for medical educationMedical education in Britain ignores insights from the psychology of learning, overloads medical students with facts, and neglects educational principles, says a new BMA report. The report recommends reform of medical education at all stages, from the undergraduate curriculum through to postgraduate and continuing medical education.It points out that doctors must be students throughout their professional careers, and it criticises the royal colleges for doing little to make improvements, although they are responsible for overseeing standards of postgraduate medical education. Instead, it says, junior doctors see the college exams as a hurdle in their careers to generate cash for the colleges, which do not give them any educational feedback when they fail.Dr Stella Lowry, BMA assistant secretary, pointed out that although there were examples of good practice, "the fact that most colleges are perceived in this way is a problem in itself, which the colleges must address." Dr Lowry was a member of the 19 strong working party, including academics, students, and representatives from all branches of the profession, that produced the report. Its efforts have been welcomed by the BMA's council.The report also recommends that postgraduate deans in England and Wales should control the whole of junior doctors' salaries, as is the case in Scotland, rather than half of them. This move would empower the deans to maintain the quality of training against opposing pressure from the managements of trust hospitals to increase the provision of services.Certain fundamental principles, which should underlie medical education at any stage, are emphasised in the report. Medical education should become more student centred, and the teacher should be a facilitator of learning rather than a provider of information. Teachers themselves need more training, appraisal, and support to develop their skills, says the report. It also says that recommendations made by the General Medical Council in 1993-and backed by this latest working party-will never be implemented without a formal structure to help staff develop professionally.But the pace of change is slow. "The General Medical Council first expressed concern about curriculum overload at the end of the nineteenth century," said Dr Lowry, "but we have to be realistic. The council gave a strong lead to the profession with its 1993 report, and all the medical Medical education doesn't necessarily prepare students to become doctors