Table 1.

Old and new apprenticeship

Prerequisites for traditional apprenticeship	Constraints in current healthcare system	Possible solutions
Clinician-teachers
Breadth	Narrowness	Avoid overspecialization in secondary care, and offer apprenticeships in primary as well as secondary care
Integrated practice	Specialization
Continuity of supervision	Discontinuity	Mentorship
Time	Lack of time	Make sessional commitments to teaching explicit
Teaching accorded high priority	Teaching below service delivery, administration and research in priority	Develop promotion tracks for educators (Ref. 34)
Themselves trained by apprenticeship	Lack of an apprenticeship tradition	Faculty development
Learning environment
Uniprofessional and collegial	Multiprofessional	Capitalize on multiprofessional teams for apprenticeship learning
Personal	Impersonal	Personalize attachments as far as possible, and make them long enough for learners and teachers to get to know one another
Person-focused	Technology-focused
Space for students	No space	Give students a base close to where care is delivered
Students living on-site	Students and staff living off-site	Organize residential apprenticeship attachments
Patients
On hospital wards	More care in outpatient department and community	Deliver it in ambulatory as well as inpatient settings
A rich casemix	Less gross organic disease, more psychosocial illness	Teach 'patient-centred care' that acknowledges the experience of illness as well as the disease process (Ref. 35)
Long stays	Short stays, if admitted at all	Follow episodes of illness across the primary/secondary care interface
Students
Manageable numbers	Huge expansion in numbers	Disperse learning and ensure individual mentorship