Abstract
Contemporary and traditional approaches to undergraduate medical education (UME) and graduate medical education (GME) are compared and differences are highlighted. A case is made that the contemporary medical education system is being subject to the downside of disruptive innovation with unintended and potentially detrimental long-term outcomes for academic medicine and clinical practice. The impact on various constituencies is discussed. Proposed solutions are presented. The challenges for education of the best possible physicians are daunting but must be met to honor the social contract between medicine and society.