Does the current version of 'Tomorrow's Doctors' adequately support the role of evidence-based medicine in the undergraduate curriculum?

Background: The evidence-based medicine (EBM) approach to clinical practice has been incorporated into medical training around the world. Whilst EBM is a component of the 'foundation years' (FY) programme, it appears to lack a firm foundation in the UK undergraduate curriculum.

Aim: To identify whether the teaching of EBM is adequately supported by the guideline 'Tomorrow's Doctors' (TD-2003).

Methods: We mapped TD-2003 against the five steps of EBM and also reviewed the literature for reports concerning the introduction of EBM into undergraduate curricula.

Results: Whilst all five steps of EBM can be mapped against TD-2003, the guidance makes no explicit reference to EBM and a coherent framework is lacking. The focus of undergraduate EBM teaching should be on 'using' research evidence (rather than undertaking research). The current emphasis on 'therapy' should be expanded to include the EBM-related issues of 'diagnosis, prognosis and harm'. UK medical schools also need to exploit the NHS investment in 'national electronic libraries'.