This edition contains a range of issues unlikely to be found in many other journals –morality implications of accreditation, sustainability, and global warming.  MacCosham et al examine the Canadian accreditation standards through a lens of ethics and morality and conclude that accreditation is an “affirmation of its duty to cultivate physicians who are clinically competent and socially responsive stewards of humanity.”  Another paper looks at sustainability in environmental projects carried out by students, while another looks at teaching about the health costs of global warming.

Health professions education for the public good, otherwise known as social accountability, remains a core theme of TUFH and this journal.  Concepts in research – who sets the agenda, who benefits from the results – is reviewed by Dalton et al using research posters presented at four global conferences as the unit of analysis.  They found a lack of alignment with institutional missions, and a lack of community engagement, demonstrating limited evidence of social accountability.  Waggie and Fish in their commentary want us to ask not what we publish but who benefits from what we publish and not what are universities good at but what are they good for.

Other important education concepts in this edition: co-design of education of community health workers, low-cost simulators, comprehensive education reform in China, teaching genetic risk assessment in Vietnam, evidence-based medicine in low-certainty clinical contexts, and the impact of prior life experiences on mental health of medical students.

Finally, the long view can be helpful in putting changes in perspective.  In this issue, a self-identified octogenarian looks at his own career trajectory and compares it to the path of today’s students.  He sees a group that is phone fixated and socially disconnected from the world around them.  The phenomenon is well described in Haigt’s book, The Anxious Generation, which focuses on a demographic cohort that came of age at the same time as smart phones.  While these devices are powerful assistants for finding and tracking information and patient engagement, the imperative of constant connection may distract from the humans in front of us.  Ethical issues related to patient confidentiality have garnered the most attention in the literature, but Foster’s point is that there is a social cost in medical education to be addressed.  Acknowledgement of people in the real world, not the virtual world, may suffer as attention is focused on digital connections.  This includes attention to colleagues, staff, and even patients.  It’s not clear how much, if any, of this behavior is a reaction to “force-fed” medical teaching as the commentator suggests, but it may be an indirect consequence as students look for a mental balm to sooth the pain of information bombardment.  There are many good reasons to balance “superficial” fact absorption with “deep learning” but it’s worth considering the psychic costs that could be pushing students to seek relief in the virtual world.