**5. Managing conflicting practice management structure, function, and economics**

To ensure its long-term viability and sustainability, medicine is a business. In fact, it is a very big, multi-sectoral business, constituting a substantial proportion of the national gross domestic product (regardless of the country or region of the globe). Various contributors to the overall "business of medicine" include pharmaceutical manufacturers, research and development, clinics and hospitals, integrated health networks, outpatient/home services, and insurance providers [24–28]. While most students are familiar with the debt component of their medical education – few understand the very complex issues that pertain to the different compensation, reimbursement, and practice models that exist. Of importance, there is a gradual

evolution from fee-for-service to pay-for-performance models. A broad-based understanding of related concepts and issues, along with how modern employment models are structured and/or function, is critical. In other words, being a competent doctor is no longer just about being a caring and compassionate individual, who is well-versed in the healing arts. An entire new skill set of an effective healthcare provider now requires one to be a well-informed and shrewd business person (or at least possess the awareness of the "business issues" involved in healthcare and the need for appropriate expertise within the greater healthcare team).

#### **6. Diversity, equity, and inclusion**

Along with a better understanding of the educational process, including more refined theories and their practical implementations, increasing awareness of the importance of diversity, equity, and inclusion (DEI) brought much-needed reforms that focused on optimization of outcomes while providing highly individualized approaches and emphasis on "building on one's strengths" [29–32]. Such concepts are becoming more and more important as physicians need to understand, appreciate, and converse with an extremely broad range of demographics and individual identities. Respect for others is a cornerstone of being a good doctor, but learning and appreciating the cultural dynamics in a rapidly changing social milieu is especially important in that inadvertent missteps might not be understood, could be taken out of context, and in some cases may not be tolerated (including various hardwired disciplinary policies and procedures) [33–35]. There is no room in society for racism, disrespect for gender or cultural identities that might be different from one's own, or biases that might impact the ability of the physician to be a leader in championing the health and overall wellbeing of a team, a community, and of society as a whole. Such foundations must be emphasized in medical school, especially when it is still common for students to have only a limited amount of exposure to meaningful diversity and inclusion initiatives. In addition, the overall complexity of the issue is further compounded by variables such as medical student age, maturity, and geo-social, cultural, and economic upbringing.

### **7. Strong foundation**

The current book is designed to provide both a strong foundation and a helpful resource for those interested in exploring ME from diverse perspectives – as educators, students, and administrators. Topics discussed are diverse, including curriculum building, nursing staff integration into teaching programs, student-guided learning, surgical education, learning through art, creation of learner support structures, the importance of mentorship, emotional intelligence, and empathy, as well as many other topics and concepts.

#### **8. Synthesis and conclusion**

The rate of change in modern ME continues to increase, and the corresponding rate of evolution within the ME system is approaching levels that exceed our ability to meaningfully adapt. Nonetheless, we must strive to be active – not passive – participants in this evolutionary process of growth and transformation. We must remember that the tools available to help with this process are in constant evolution – a concept that can be both good (immediate availability of knowledge to all)

## *Introductory Chapter: Medical Education at the Crossroads - Things Are Not How They Used to Be… DOI: http://dx.doi.org/10.5772/intechopen.104692*

and bad (biased, conflicting agendas, non-peer-reviewed content) – and therefore significant level of mastery is required. Furthermore, comprehensive medical education is no longer limited to learning about the normal and abnormal structure and function of the human body and how to treat disease, but also the complex social challenges that patients face, how to effectively function in a healthcare environment and team, and the importance of a solid foundation in various business aspects of healthcare. The challenges facing the current generation of students may seem overwhelming to medical students of the past, but the tools and opportunities for success – as outlined in this text – when used properly are all geared towards facilitating the educational process to be more efficient and effective in ways that were never available in the past. In brief, now is a great time to be a medical student – and probably more so than ever before!
