The Education of Medical Students

Moving Beyond Flexner

Providing high quality medical care to the American Public is the greatest contemporary challenge

facing American medicine.

Crossing the Quality Chasm. A New Health System or the 21st Century. Institute of Medicine, 2001

“Education for the health professions is in need of a major overhaul. Clinical education simply has not

kept pace with or been responsive enough to shifting demographics and desires, changing health system expectations, evolving practice requirements and

staffing arrangements, new information, a focus on improving quality, or new technologies.”

Redesign of Clinical Education- AAMC agenda -

• AAMC Project on the Clinical Education of Medical Students (2000 +)

• Millennium Conferences (2001 & 2002)

• Clinical Skills Education Project (2003-4)

(over 50 medical schools involved in activities)

Redesign of Clinical Education- IOM: important gaps -

Interdisciplinary team care

Focus on patient-centered care

Evidence-based practice

Quality improvement principles

Informatics

Redesign of Clinical Education- AAMC: serious shortcomings -

Inadequate exposure to developmentally appropriate clinical conditions

Inadequate attention to the teaching and assessment of fundamental clinical skills

“The time has come to focus energy and resources on ….. what educational content matters for patient care and what works in

teaching clinicians so that educators ….. can assess objectively what needs to be

emphasized in the health professions curricula and what should be eliminated.”

Health Professions Education. A Bridge to Quality. Institute of Medicine, 2003.

Redesign of Clinical Education

The Challenge for Schools

• acknowledge the need for change – discard the old arguments about the status quo

• be open to the possibility that very dramatic changes may be needed

• recognize that informed intuition is adequate for designing a new approach

Redesign of Clinical Education

The Challenge for Schools

required clerkships - ????????????????

design & conduct of clerkships - ?????

sites for clinical experiences - ????????

faculty roles and responsibilities - ?????

Redesign of Clinical Education

The Challenge for Schools

Create a vision and strive to achieve it!