The 1990s ended optimistically for the United States and for pediatric education:
the country had accumulated a financial surplus, the pediatrics community had come
together to deliberate the Future of Pediatric Education II, and medical education
had a new paradigm (the Outcome Project). The past decade has been a tumultuous one,
and optimism is now tempered by concerns and questions. Any attempt to discuss medical
education needs to take into account the societal forces that affect health care,
which is the context for medical education. Of the 10 issues addressed in this article,
the first 5 are societal factors with implications for education; the last 5 are issues
within medical education, with emphasis on pediatric education. The 10 are discussed
individually but clearly interact and overlap. The order in which they are discussed
is not intended to convey a rank of importance.
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