The domestic relationship between the health care provision system and the content and processes of medical education defies easy classification. It is not even clear that the two are legally married, though there is certainly a common-law union. Often they are estranged, and at times they appear quite divorced. Yet they have been living with each other, more or less, for a long time now, and this uneasy cohabitation yields more than 9,000 offspring every June when new professional birth certificates, or diplomas, are issued to medical school graduates.
I hasten to add that I intend no reflection on the legitimacy of those graduates! But certainly, as this metaphor suggests, the relationship is more complex than that implied by the title. The health care system does more than provide care; it also acts powerfully (though latently) to educate students and new professionals in particular ways. The medical educational system does