Transforming Health Professionals' Education

In their Commission report (Dec 4, p 1923), Julio Frenk and colleagues highlight the expansion of “academic centres” to “academic systems” as a key process in the transformation of health profes sional education for a new century. New curricular strategies are fundamental for the realisation of their vision. In the medical education setting, increasing use of longitudinal integrated clerkships has provided initial insights for institu tions that wish to improve their clinical pro grammes. I write to propose an expansion of that concept to a “health-system-based clerkship”, adapting the ideas published in Brazil by my colleagues and I. Ideally, a health-system-based clerkship would provide clinical medical training nested into a national health system, encompassing regional networks of primary care centres, outpatient clinics, and hospitals, with primary care as the clinical backbone that coordinates and longitudinally integrates scenarios, practices, and training. Such a programme could enhance meaningful interprofessional education for medical students, favouring continuity of training and care, patient and communitycen tredness, and social accountability. This kind of pedagogic approach could cover the diversity and complexity of clinical experience and education expected for the new century’s doctors in an “academic system”.