CHICAGO — When Susan Skochelak, M.D., recently sat down to talk about the American Medical Association's $10 million effort to kickstart the transformation of medical education, she offered a good account of why it was needed.
Skochelak, AMA group vice president of medical education and director of the association's Center for Transforming Medical Education, described how the world of health care is changing drastically in areas such as reimbursement and technology, and medical education needs to change with it.
Now we know more about how medical education might change. The AMA announced the 11 recipients of its transformation grants, which were increased in size to $11 million over five years.
The projects range from Indiana University School of Medicine's plan to create a virtual health care system and a teaching electronic medical record to a proposal by Brown University's Warren Alpert Medical School to establish a dual MD-MS degree program in primary care and population health.
Population health is a recurring theme in the proposals, but the concept of focusing on med students' competencies rather than completion of a curriculum also showed up repeatedly.
At the University of California–San Francisco School of Medicine, the grant will fund a project that will include an accelerated, competency-based curriculum designed so that from Day 1 of medical school students actively be a part of the health care system while learning competencies needed to provide care for patients and populations. Competency-based assessments will allow students to complete core learning in an accelerated time frame.
Similarly, Vanderbilt University School of Medicine will embed students in the health care workplace, working at a single clinical location throughout their first round of medical education.
Competency-based performance data will allow students to graduate in less than four years.
According to Howard Bauchner, M.D., editor-in-chief of the Journal of the American Medical Association, that's just what health care needs, a medical education process focused more on skills. At an early session of the AMA's annual meeting in Chicago, Bauchner lamented the entrenched nature of medical education's formula: Four years of undergraduate education + four years of medical school + three to five years of residency.
Suggestions for broader ways education could be improved, per Bauchner: switch to competency-based education and do away with the calendar-driven approach; combine medical school with residencies; combine residencies with fellowships; or have health care systems develop their own schools and residencies.
The current model has been virtually the same for six decades, he says. "Some of these things are going to have to change."
My colleague Marty Stempniak and I will be reporting from the AMA meeting all week, so look for our reports in H&HN Daily.