Generally Speaking

Nicholas J. Pisacano, MD
JAMA. 1970;213(3):432-433. doi:10.1001/jama.1970.03170290028005.
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I would like to set out with a few simple but sweeping generalizations concerning the impact of medical education on the practice of medicine. These generalizations are also, in general, negative. I make no apology for being negative nor do I subscribe to the sophistry of the academic world which implies that generalizations are necessarily false and lead to illogical conclusions.

My first generalization, then, is (1) that medical schools have contributed little toward the improvement of the practice of medicine; (2) that, in fact, medical educators have very little understanding of what comprehensive medicine truly is; (3) that the rise of the newest approved specialty, family practice, after many abortive attempts at approval, owes little to medical educators for its eventual success in attaining approval on Feb 8, 1969; and (4) that, even in the light of this recent surge of interest in family practice, many deans and/or their


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