Education-Medical Ethics-Legal controls-Criticism of Modern Medicine

Medical education and training varies around the world. It typically involves entry level education at a university medical school, followed by a period of supervised practice or internship, and/or residency.This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a Doctor of Medicine degree, often abbreviated M.D. or a Doctor of Osteopathic Medicine degree, often abbreviated as D.O. and unique to the United States, must be completed in a recognized university.

Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education. The means through which doctors upgrade their medical knowledge include medical journals, seminars, conferences and online programs apart from others.

Medical ethics

Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. Six of the values that commonly apply to medical ethics discussions are:

• autonomy - the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
• beneficence - a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)
• justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).
• non-maleficence - "first, do no harm" (primum non nocere).
• respect for persons - the patient (and the person treating the patient) have the right to be treated with dignity.
• truthfulness and honesty - the concept of informed consent has increased in importance since the historical events of the Doctors' Trial of the Nuremberg trials and Tuskegee syphilis experiment.

Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. When moral values are in conflict, the result may be an ethical dilemma or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i.e., the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members. For example, some argue that the principles of autonomy and beneficence clash when patients refuse blood transfusions, considering them life-saving; and truth-telling was not emphasized to a large extent before the HIV era.

Legal controls

In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health.

In the European Union, the profession of doctor of medicine is regulated. A profession is said to be regulated when access and exercise is subject to the possession of a specific professional qualification. The regulated professions database contains a list of regulated professions for doctor of medicine in the EU member states, EEA countries and Switzerland. This list is covered by the Directive 2005/36/EC .

Doctors who are negligent or intentionally harmful in their care of patients can face charges of medical malpractice and be subject to civil, criminal, or professional sanctions.

Criticism of modern medicine

According to Paul Farmer, the main problem for modern medicine is lack of access in poor regions. There is an "outcome gap" between the rich and poor that is most noticeable with expensive-to-treat diseases like AIDS and tuberculosis. The majority of medical resources and therapies are concentrated in the rich, low-incidence regions such as the West. On the other hand, countries in the developing world have high rates of HIV but lack the resources to treat them.

Medical errors and overmedication and other forms of iatrogenesis (harms caused by medical treatment) are also the focus of complaints and negative coverage. Practitioners of human factors engineering believe that there is much that medicine may usefully gain by emulating concepts in aviation safety, where it is recognized that it is dangerous to place too much responsibility on one "superhuman" individual and expect him or her not to make errors. Reporting systems and checking mechanisms are becoming more common in identifying sources of error and improving practice. Clinical versus statistical, algorithmic diagnostic methods were famously examined in psychiatric practice in a 1954 book by Paul E. Meehl, which found statistical methods superior. A 2000 meta-analysis comparing these methods in both psychology and medicine found that statistical or "mechanical" diagnostic methods were, in general, although not always, superior

Disparities in quality of care givenamong local demographics are often an additional cause of controversy.For example, elderly mentally ill patients received poorer care duringhospitalization in a 2008 study. Rural poor African-American men were used inan infamous study ofsyphilis that denied them basic medical care.The highest honorawarded in medicine is the Nobel Prize in Medicine, awarded since 1901 bythe Nobel Assembly at KarolinskaInstitutet.