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Leadership development: prerequisite for successful public-private partnership. New challenge for medical schools: graduates' outcome competences in health leadership.

Medical education stands at the doorstep of profound change, forced to step into an uncertain and potentially hostile new environment. These changes have nothing to do with scholar self-reflection, but rather are a direct consequence of the process of globalization visible also in medical education and the revolution in health care financing for which we use the general term "managed care". On one hand, globalization has penetrated different areas of our life, among others including science, public health and medicine which is a global profession. Medical knowledge, research and education have traditionally crossed national boundaries. Many aptitudes of physicians are universal, as well as the core competencies required by physicians throughout the world. The question is "what kind of core or essential competences are required for "global physicians". Besides medical knowledge and basic clinical skills, professionalism, interpersonal communication skills, context of care, information management, understanding a health system, etc. also need to be addressed. On the other hand, there is a growing concern that the corporate transformation of medical care, especially related to the impact of the changing and more business-oriented health care system, may lead to the decline and death of traditional professional values, such as fidelity, altruism, confidentiality, and integrity. No doubt, there is an inherent clash of values between business and medicine. However, as business interests have already gained an important place in medicine, we can hope that physicians progressively adopt a business mentality without losing professional virtue. While occurring changes inevitably bring some sense of loss, it also brings an opportunity to help reshape medical education to better meet the health needs of society.