Continuing Medical Education: Looking Back, Planning Ahead

Foreword

ix C. Everett Koop Foreword When I graduated from Cornell University Medical College in 1941, I thought I was brimful of knowledge, ready to be a doctor and to bring my skills to patients. Little did I know that my learning had just begun and, even more important, that much that I had been taught would soon become obsolete if in fact it hadn’t been wrong in the first place. I am now ninety-three years old and, after sixty-nine years in medicine, I continue to be astounded about how medicine has changed in my lifetime. I also continue to be blessed by associating with young colleagues who are bringing about changes that I could have never dreamed of in practice and in the understanding of disease, sometimes utilizing fields of inquiry and discovery that didn’t even exist when I began to practice. I have also been blessed to have been a surgeon at a time when I had the privilege to help shape the new and evolving field of pediatric surgery . My colleagues and I learned daily, especially from our patients and their families, as we pushed boundaries and shaped and marveled at the incredible progress being achieved. Those were exciting and meaningful times for medicine and for me personally. Later in my career, I had the wonderful opportunity to move from the field of surgery (caring mostly for individual patients) to a whole new world of public health when I became your surgeon general for two terms. It was then that I saw firsthand the power of prevention and the fruits of teamwork between doctors and other professionals to bring about important transformations in health and health care. I came to appreciate, as never before, the social and cultural determinants of illness and the fact that indeed it does take a village as the best way to bring about e√ective and lasting change. Many of these villages of change were inhabited by courageous and forward-thinking heroes—pioneers who would not accept the status quo and bravely led us to better futures. Now in my retirement at Dartmouth, where I founded the Koop Institute to help inspire young people entering medicine as I had been inspired, I continue to be astounded by the bright young people I encounter and the progress they are making. I learn something new every day, and I think that fact in itself is one of the most appealing aspects of my journey in this profession. We have come so far and are poised on the cusp of so much more progress. It has been an incredible journey since my medical school days, and I treasure the memories of all my teachers who inspired me along the way. When I started out, the formal discipline of continuing medical education (CME) did not even exist. Yet, as I think of a physician’s life, I realize that medical school and residency/ fellowship training, which do have a very important role in the formation of physicians and receive a lot of attention by educators and leaders in medicine, do not represent the conclusion to one’s medical education. So much of how medicine is practiced is learned in the years beyond residency. My most important educational experiences occurred in practice, and they happened every single day. They shaped me, my practice, and medicine in general more than I would have ever imagined from the vantage point of medical x foreword school or residency. Most of my real education came in those years that CME should have been the most important resource. But, even with this realization and all of the important developments that have formed the field of continuing medical education, it is not enough—yet. This is why I think Continuing Medical Education: Looking Back, Planning Ahead, by Dennis Wentz and colleagues, will be an important milestone document in the field. The work in this book reminds me of a painting, Gauguin’s famous triptych Where Do We Come From? What Are We? Where Are We Going? This book describes those three spaces or phases of CME, with the most important and exciting being where we will go. In these times of rapid change, we need e√ective continuing education to bring discoveries to the bedside, to the community, and to the fostering of health in general. In this era of health-care reform, CME will help us to learn to do it wisely, well, safely, and right. Discovery is happening...