Back to the Future for Medical Schools: New Ideas Aim to Revolutionize a Doctor’s Education

Jun 24, 2014, 5:07 PM

During this week’s Spotlight: Health at the annual Aspen Ideas Festival, Cleveland Clinic CEO Toby Cosgrove, MD, will be talking about the future of academic medicine. The topic has received a great deal of attention recently, including a white paper from the Bipartisan Policy Center (BPC) and a pilot program from the American Medical Association (AMA) to give $1 million each to eleven medical schools redesigning their teaching programs—many of which include a focus on prevention, wellness and population health.

Teamwork is a recent and critical emphasis at the Cleveland Clinic Lerner College of Medicine, said Cosgrove in a conversation with NewPublicHealth ahead of the Aspen conference.

“When a lot of us went to medical school we were all taught to be rugged individuals, and so [now] we’re trying to teach teamwork...at the very beginning of health care education,” he said. To that end, instruction at the medical school now emphasizes team-based learning and the students will begin doing some of their work with nursing and dental students in the same physical facility “so we begin to break down the silos that are going on right now and encourage team play.”

The 11 medical schools that received the recent AMA grants were chosen from among 119 schools that submitted proposals. “Their bold, transformative proposals [are] designed to close the gaps between how medical students are trained and how health care is delivered,” said former AMA President Jeremy A. Lazarus, MD, when the AMA awarded the grants last year. Among the winners:

  • The Alpert Medical School of Brown University, which has proposed establishing a dual MD-MS degree program in primary care and population health. A clerkship during the third year of medical school will integrate care of the individual patient and population health, and the fourth year will include population health course content and require a Master's thesis. The admissions process will include required interviews with stakeholders and patients.
  • The University of California-Davis School of Medicine is partnering with Kaiser Permanente to create the Accelerated Competency-based Education in Primary Care (ACE-PC) program, which will require all students to work in the Kaiser Health system so that they can learn by experiencing the patient-centered medical home model. Changes to curriculum include population management, chronic disease management, quality improvement, patient safety, team-based care and preventive health skills, with a special emphasis on diverse and underserved populations.

The eleven schools won’t be working in silos, either. Susan Skochelak, MD, the AMA’s group vice president for medical education, told NewPublicHealth that the initiative was designed “very specifically to bring the schools together in a consortium, because we wanted to disseminate the best practices rapidly.” 

Skochelak said the schools are meeting regularly, sharing their successes and challenges while picking up ideas from each other. The AMA has invited other schools to participate by joining the initiative meetings or at national conferences where the AMA has been presenting on the projects.

The BPC white paper released this week, “Teaching Nutrition and Physical Activity in Medical School: Training Doctors for Prevention-Oriented Care,” is focused squarely on prevention and wellness, calling for all medical students and physicians to be trained in nutrition and physical activity as a way to help combat America’s growing obesity problem. The report found that more than 75 percent of physicians felt they had received inadequate training to be able to counsel their patients on changing diet and increasing activity levels, and that fewer than 30 percent of medical schools meet the minimum number of hours of education in nutrition and exercise science recommended by the National Academy of Sciences.

Key recommendations of the white paper include:

  • Licensing and certification exams, as well as residency and continuing education programs that include more nutrition and physical activity content.
  • Federal and state governments should provide support for reforms in medical education and health care delivery that can help providers better meet patient needs with respect to nutrition, physical activity and other lifestyle factors.

Of course, technology is also a focus of improving medical school education. Earlier this week, close to 200 academic physicians discussed the role of technology in medical education during a meeting at the Harvard Medical School. The AMA is also looking at how students can use burgeoning technology for medical practices more accurately and effectively, such as patient simulations and electronic health records.

This commentary originally appeared on the RWJF New Public Health blog.