Abstract
The observation that medical education is not particularly relevant to medical practice tends often to be dismissed as yet another dazzling glimpse of the obvious or as a description of an appropriate state of affairs, to be cherished rather than challenged. I will address myself to the inappropriateness of both these responses and examine the depth and the danger of the disparity between education and practice. Medical care in this country has come to be frequently referred to as a "nonsystem." For many of the same reasons, medical education must also be regarded as a nonsystem. In both spheres, current patterns have emerged from gradual, largely unplanned, evolution, rather than having been guided by either informed leadership or systematic research. Those largely anonymous individuals who have contributed to the shaping of our present programs of undergraduate medical education were equipped with generous quantities of good will and intuition which, regrettably,

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