New models or remodeling students or both

In the US, medical education does well in developing academic skills, however medicine is much more than academics. Few medical students are prepared for the challenges that await them after the completion of formal training. Relationships with patients, staff, and communities are a particular challenge. Some physicians may choose specialties to ensure that they avoid such challenges. However those who hope to become deans, medical leaders, rural physicians, or primary care physicians must develop significant expertise in these areas. Physicians also face challenging social issues and are important leaders in the process of organizing communities for improved health care. Despite an increasing body of evidence regarding the need for improvements in training, these areas await the attention of US medical education leaders. The probability of including these areas within formal training seems to diminish with each passing year. In the meantime US medical schools are admitting a much narrower medical student, one who is even less prepared to address these areas before, during, and after medical school. US medical schools are also graduating fewer family physicians, the ones who will be forced to develop these areas more than any other physicians.