Modern medical training risks depriving undergraduate doctors of basic knowledge, a report warned.

The authors, Professor Gareth Williams, Dean of Bristol University Medical School, and fourth-year medical student Alice Lau, claim reforms in teaching may have dire consequences for patients and the future of the profession.

Students risk becoming poor clinicians with inadequate knowledge if traditional ways of teaching medicine are replaced by a new problem-based learning strategy, according to the report published in the British Medical Journal.

One-third of UK medical schools, including Liverpool and Manchester, have already moved away from in-depth teaching of subjects like anatomy, pathology, and pharmacology. Instead undergraduates learn by solving problems.

The report warns the new methods could lead to a gap in knowledge and affect a doctor's ability to diagnose and treat illnesses.

The reforms, endorsed by the UK General Medical Council, have been praised for liberating students from the drudgery of learning facts while improving their problem-solving skills. Prof Williams and Ms Lau claim there is no evidence to prove the new strategy is effective.

They argue it deprives students of contact with inspirational teachers and reduces their depth of medical knowledge.

The report said: "Becoming a proficient doctor has always demanded hard work so it is unacceptable to leave out large parts of the curriculum simply because there is a lot to learn.

"Educational reform is being driven by an evangelical zeal for change, rather than by rational responses to the shortcomings of the traditional curriculum.

"The training of doctors is too important an activity for bold experiments to be conducted before discovering what actually happens."

The authors have called for a rigorous comparison of traditional versus new methods to determine the best strategy for training doctors.

A Department of Health spokeswoman said: "There is absolutely no question of dumbing down training.

"For the first time, competencies will be described and explicit standards set.

"It will be possible for patients to see what knowledge and skills a doctor in training should have.

"This will create doctors who are fit for purpose. For example, not all doctors need to know how to perform lung transplants.

"What we need is doctors who are competent to deal with what the service needs."

Monday July 12, 2004