Summary: It is time to review the reasons for including public health in medical education. Undergraduate medical students are interested above all in the diagnosis and treatment of individual cases of disease; population-based health care means little to most students, and is seldom regarded as important. Should public health teachers concentrate their efforts in other areas, where students are more receptive? This paper presents arguments for and against the proposition that public hearth has no place in the undergraduate medical course.
In favour of the proposition, it is argued that the clinical imperative is so firmly entrenched in the minds of students and in the cultures of medical schools that public health will always be diminished and elbowed to one side in medical curricula. Moreover, the major gains in the health of populations will be won in other arenas. Therefore public health should rupture the links with medical schools that were formed in another age and, in any event are now weakening as public health strikes a new identity. The effort that currently goes into teaching unwilling medical students would have better returns if it was invested elsewhere.
Against the proposition, it is argued that the health of populations will not be improved without participation of all groups with an interest in and an influence on health care. No group is more influential in the organization and delivery of hearth services than the medical profession, so it would be foolish for public hearth to withdraw from medical education. Moreover, effective medical practice requires an ability to think in terms of populations as well as individuals. Public health cannot be taken out of medical education – it is just a question of whether or not it is done well.