American medical education is under continued study, and reforms are being suggested to improve it. The current paper reviews the standard U.S. medical school curriculum and discusses suggestions for change. Medical education must become more student- and learning-oriented, must place more emphasis on primary care, and must use new settings for education. The paper also examines the reasons that medical schools fail in their education mission.

Once dependent on the educational and professional resources of other countries, by the end of World War II the United States was recognized as one of the preeminent centers of the world for medical science and teaching. A period of nearly open access to the American medical education system between 1962 and 1975 was followed, however, by a period of stricture. Reasons are cited in favor of a more active international role by the United States in medical education. Some of the contributions that the United States can make are summarized, and seven areas are identified in which the United States stands to make substantial gains through a more active role in international medical education. The authors conclude that it is the spirit of science, rather than diplomatic advantage, that should guide United States efforts in international medical education. A proposed role for the Association of American Medical Colleges as both a facilitator and a national policy advocate in the area of international medical education and health is outlined.

Since 1970 the Association of American Medical Colleges (AAMC) has had two key policies about minorities in medicine: (1) special attention should be paid to minority groups underrepresented in medicine, and (2) minority groups should be represented in medicine in the same proportions as in the population as a whole. Despite strong gains in the 1970s in increasing the number of black trainees and graduates, the proportion of minorities in medicine now is declining in relation to the total population. The paper discusses this situation, changes in U.S. minority populations, factors that affected the attempt to achieve parity in medicine, the current status of minorities in medical training (including educational debt) and on medical faculties, and remedies for institutions' lack of success in achieving parity. Three successful programs are described, as are the broader social issues that underlie academic medicine's attempt to increase the proportion of minorities in medicine.

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