Curricular Transformation: The Case Against Global Change

In this Commentary, the authors make the case for medical schools to pursue more circumscribed solutions to curricular redesign for undergraduate medical education rather than whole system changes-at least as first steps and perhaps as ultimate solutions. Although they focus primarily on the experience at the Warren Alpert Medical School of Brown University (AMS), they believe that the insights gleaned from their experiences are generalizable to other innovations and other medical schools. The authors describe the implementation of the Primary Care-Population Medicine track at AMS as a working example of implementing circumscribed rather than global change, and they discuss the advantages and disadvantages of such an approach to curriculum transformation.