With the changing landscape of health care in the United States, the way in which medical schools train the physicians of the future also must change. To be effective, continuous enhancement of the curriculum is not enough. The process of medical school education needs a dramatic shift.
Traditionally, the basic structure of medical school education has been a focus on science (fundamental classroom work) for the first half and clinical experiences for the final two years. In the clinical area, medical schools have concentrated on training for acute care situations and crisis management in hospitals.
That needs to be turned around by training students in disease management with a goal of avoiding hospital admissions.
The healthier we keep our population, the greater effect we will have on managing costs and improving outcomes.
Without a transformation in medical school education, new physicians will not have all the skills needed to face the realities of the new world of health care.
Medical School Innovation
Innovation in medical education is not a new concept. Some schools use a basic science curriculum of 18 months instead of 24. That extra time provides students with the flexibility to take additional courses in areas like health policy, ethics, patient safety and quality, physician communications and care of the underserved. Or, students can engage in a research project or work in a different environment or global setting. That innovation lets students graduate with a broader appreciation of health care.
Another innovative concept is introducing the first clinical contact with a patient much earlier. By seeing a patient within weeks of beginning medical school, students are able to connect the scientific knowledge they are absorbing to the care of a person.
Courses on ethics, leadership, medical informatics, communication and transitioning to residency are also important to successfully preparing a new physician, while curriculums are constantly updated to include important issues.
Another innovation is to see patients of all backgrounds and cultures in many different settings – at private hospitals, at large public hospitals, at community clinics, large children’s hospitals, veteran’s hospitals, women’s hospitals, and outpatient clinics.
But that is not enough.
The Look of the Future
Medical students must be prepared to be the best physicians in the future, and the future has a new look.
That look includes:
Serving a community by providing high quality, safe and efficient care requires knowing that community, understanding its health needs and studying the best approaches to lessen the health risks in the population.
Physicians should not be exposed to these issues for the first time after training. To be more effective, these areas should be part of a medical school education:
If students understand first-hand how to change the system to provide high quality care for more people efficiently, safely and at the lowest possible cost, and to address specific health care needs within the community, they will be better physicians. They certainly will be better trained to meet the issues they will face from their first day as an M.D.
Focus on Faculty
The only way to ensure medical students get the best possible education is to have the best faculty. Today, medical schools must place the same, if not greater, value on the faculty’s role as educators as they have with clinicians and researchers.
One way to do that is to quantify the educational contributions of faculty so they can be weighed and measured in comparable terms to publications, grants, and clinical activity. These awards create measurable milestones and can be factored in for academic promotion.
Developing faculty and recognizing faculty who provide education to students should be highly valued, and rewarding their talent reinforces their abundantly valued contributions.
Change Has Begun
In flipping the medical education process, there is much to do, and the change has begun.
A new look to providing health care has arrived. Everyone in medical education owes it to the patients and the state of Texas to provide the best care in an efficient, safe system at the lowest cost possible.
Paul E. Klotman, M.D. is the CEO of Baylor College of Medicine, ranked one of the best medical schools in the U.S., and the top-ranked medical school in Texas. BCM is in Houston.
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