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On a Contradiction Between Intent and Enactment

Arch Intern Med. 1970;126(6):1070-1072. doi:10.1001/archinte.1970.00310120132017.
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There is a seemingly unresolvable contradiction written into the design of most university training programs for physicians. The contradiction relates to what medical schools and university medical centers say they wish to accomplish and what actually takes place in the course of the seven to ten years that a physician is being developed within most of the traditional programs that now exist. The consequence is not what is popularly termed the "town gown" conflict; it is a much more important conflict that resides disturbingly within the individual physician, whether he goes "abroad" into the community (as most graduates do) or stays within the university and continues to replicate the contradictory process.

University medical centers have enunciated the following goals:

To create competent, scholarly practitioners of the profession of medicine and associated health science disciplines;

To provide effective and efficient arenas where innovative and scientifically rigorous health care services are provided;


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