Invited Commentary

Commentary on "Time to Dedifferentiate"

Authors: Irene Alexandraki, MD, MPH


Medical education has continued to evolve since the Flexner report was published more than 100 years ago. Perpetual changes in the healthcare delivery system and societal expectations for high quality in both medical training and practice have led to a reform in medical education. A snapshot of medical education in the United States in 2010 highlighted the advances in pedagogy and the curricular redesign that have been occurring.1 Clinical experiences have become a point of significant change. In most medical schools, clinical experiences are integrated with basic sciences and delivered longitudinally in the curriculum, beginning early in the first year. Moreover, the increase in medical school enrollment, along with the establishment of new medical schools in recent years call for an expansion in the number of available clinical sites and highlight the need for a larger cadre of skillful clinician-educators.1

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Anderson MB, Kanter SL. Medical education in the United States and Canada, 2010. Acad Med 2010;85(9 Suppl):S2-S18.
2. Manian FA. Time to dedifferentiate. South Med J 2015;108:198-199.
3. Harbuck S, Follmer A, Dill M, et al. Estimating the number and characteristics of hospitalist physicians in the United States and their possible workforce implications. AAMC Anal Brief 2012;12:1-2.
4. Harrison R, Allen E. Teaching internal medicine residents in the new era. Inpatient attending with duty-hour regulations. J Gen Intern Med 2006;21:447-452.
5. Goldenberg J, Glasheen JJ. Hospitalist educators: future of inpatient internal medicine training. Mt Sinai J Med 2008;75:430-435.
6. Hollander H. Response to the effect of hospitalist systems on residency education: re-incorporating medical subspecialists. Acad Med 2001;76:555-556.