Great contingencies, and COVID-19 can undoubtedly be classified as such, give rise to both 'changes out of necessity' and 'changes in the rate' of processes that were undergoing transformation. We can take it for granted that COVID-19 will affect medical education by introducing both types of changes, involving 'necessity' and 'rate', and that, furthermore, these changes will have an impact on the three classic stages of medical education, that is, undergraduate education, specialised training and continuous medical education. And they will certainly have a more pronounced effect on the first, undergraduate medical education, and the last, continuous medical education.

From the Medical Education Foundation (FEM) we want to reflect upon the scarcity of measures taken to renew the contents, methodologies, teaching strategies, methods of assessment and even the analysis of the citizens' needs in the medical education of our country. If we are honest, we can spot large gaps in each of the sections mentioned. Over time we have become convinced that our doctors are excellent, that our healthcare system is extraordinary and that the MIR exam is an example of fairness. And by repeating it and boasting about it, we haven't seen the need update the contents or the methodologies or the assessment instruments or the strategies, and neither have we analysed the needs of citizens. A clear example evidenced by COVID-19: in undergraduate training, specialised training or continuous medical education was the emphasis on public health? And it isn't because, modestly, the FEM, but above all experts from Harvard University and other prestigious institutions have failed to stress the need to reorient the curricula more towards preventive medicine and public health.

Now in no way are we going to claim, or even imagine, that our doctors are bad - that is obviously not true. Neither will we dare to suggest that our healthcare system is not excellent; although expensive, it is of high quality. And neither will we imply that the MIR test is not fair, as it undoubtedly achieves a fair distribution of future residents. But as experts in medical education or simply as a duty of intellectuals forged in the academic world, we admire ourselves for not having collectively posed questions like: Can our doctors be even better? Can our healthcare system meet citizens' needs better? Could the fair and equitable distribution of graduates entering the specialised training programme be improved? And the answer to all of three of them is yes. Yes, we can train doctors better, we can redirect the health system (for example, in the fields of public health or functional diversity) and we can improve the MIR exam.

Before COVID-19, the FEM had no doubts that it was a need to improve doctors' education in the three periods: undergraduate, specialised and continuous medical education. But the post-COVID-19 'next normal' makes it even more necessary.

The intention of the FEM is none other than to try to ensure that, after the COVID-19 pandemic, the debate on doctors' education emerges with force. We understand that to deal with the new post-COVID-19 'normal' it is our obligation to suggest, stimulate and prompt a debate on the education of physicians in medical schools. It is our obligation to stop singing the praises of the MIR exam and to highlight its weaknesses with the sole aim of improving it and in no way looking to blame anyone. And finally, it is our obligation to tackle the points in need of improvement in continuous medical education in order to adapt it to the new needs, new requirements, new methodologies and new strategies. In relation to continuous medical education, let me remind you of a position that is especially far removed from reality that occurred not so long ago and which, in hindsight, should surprise us. During the creation of the continuous medical education National Accreditation System in 1999 - a process that I experienced first-hand - the accreditation of distance learning was left for study at a later date, since reputable and well-known colleagues argued vehemently that distance training activities could not be accredited. What do you think much of the post-COVID-19 continuous medical education will be like? Have no doubt: education will be largely delivered at a distance. And for the record I would like to say that the reputed colleagues to whom I have just referred were not mistakenly defending what has been shown to be an error. Indeed, if were 'guilty' of anything at all, it was their failure to foresee the future of information and communication technologies.

As you will probably have noticed, at the end of the title of this editorial there is a '(I)', which is indicative of our intention to publish further editorials with the same title that will propose specific post-COVID-19 changes in different aspects of medical education. The purpose of this first editorial is to introduce the subject of changes in medical education, and in future editorials we will delve into possible changes in undergraduate medical education (II), in continuous medical education (III) or in other relevant aspects. Any suggestion or response, any question or contribution will be welcome and undoubtedly enriching.

I would like to end this editorial with one last thought. In recent years, in medical practice we have learned to respect the primacy of the patient. The patient is the owner of his or her health and therefore of any decisions that affect it. The physician is no longer the only protagonist in deciding what is good or bad for the patient. So, in medical education we have to fully assume that in the teaching-learning process the main character is the person who is learning, that the important thing is that the learner learns and that the teacher is the best guide and the best partner in the process of learning to be a doctor. Before COVID-19 we talked about 'improving medical education'. After COVID-19 we would like to see that our primary concern is with 'improving the learning' of doctors. Please help us to reflect upon that.