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The article focuses on a series of strategies adopted by Chancellor Carol Aschenbrener to prepare the University of Nebraska Medical Center (UNMC) in Omaha, in facing market challenges. The strategies include total quality management, cultural diversity, and values for excellence. The successful implementation of the strategies depends largely on the effectiveness of UNMC in addressing people-related issues. The human resources was repositioned as a strategic function engaged in driving organizational change through the appointment of a new chief human resources officer position. It was created to report directly to the chancellor. In 1995, a team engaged in a repositioning process, resulting in a human resource strategy that supported the continued success of UNMC.

Background: The medical education system based on principles advocated by Flexner and Osler has produced generations of scientifically grounded and clinically skilled physicians whose collective experiences and contributions have served medicine and patients well. Yet sweeping changes launched around the turn of the millennium have constituted a revolution in medical education. In this article, a critique is presented of the new undergraduate medical education (UME) curricula in relationship to graduate medical education (GME) and clinical practice. Discussion: Medical education has changed and will continue to change in response to scientific advances and societal needs. However, enthusiasm for reform needs to be tempered by a more measured approach to avoid unintended consequences. Movement from novice to master in medicine cannot be rushed. An argument is made for a shoring up of biomedical science in revised curricula with the beneficiaries being nascent practitioners, developing physician-scientists --and the public. Conclusion: Unless there is further modification, the new integrated curricula are at risk of produce graduates deficient in the characteristics that have set physicians apart from other healthcare professionals, namely high-level clinical expertise based on a deep grounding in biomedical science and understanding of the pathologic basis of disease. The challenges for education of the best possible physicians are great but the benefits to medicine and society are enormous. [ABSTRACT FROM AUTHOR]