Medical education in the United States of America (original) (raw)

The Current Format and Ongoing Advances of Medical Education in the United States

Journal of Craniofacial Surgery, 2014

The objective of this study was to examine the current system of medical education along with the advances that are being made to support the demands of a changing health care system. American medical education must reform to anticipate the future needs of a changing health care system. Since the dramatic transformations to medical education that followed the publication of the Flexner report in 1910, medical education in the United States has largely remained unaltered. Today, the education of future physicians is undergoing modifications at all levels: premedical education, medical school, and residency training. Advances are being made with respect to curriculum design and content, standardized testing, and accreditation milestones. Fields such as plastic surgery are taking strides toward improving resident training as the next accreditation system is established. To promote more efficacious medical education, the American Medical Association has provided grants for innovations in education. Likewise, the Accreditation Council for Graduate Medical Education outlined 6 core competencies to standardize the educational goals of residency training. Such efforts are likely to improve the education of future physicians so that they are able to meet the future needs of American health care.

Trends in North American medical education

The Keio Journal of Medicine, 2005

Abstract. Medical education in the United States of America (USA), and worldwide, is increasingly concentrating on the process and outcome of the educational experience. The first efforts to substan-tially improve medical education in the USA resulted in the Flexner Report in the ...

Medical Education-Where Do We Stand?

Pakistan Postgraduate Medical Journal

We were taught in a traditional curriculum. Learner was not an active participant in determining a learning plan. Stress was on Content-Knowledge acquisition. Path of learning was from teacher to student as the content was decided by teacher. Learning was in class rooms and not with reference to actual life situations. It was noncontextual. Teaching was discipline based and student was a passive recipient of knowledge. Typical assessment tool was single subjective measure: viva-voce, Long essay questions or Multiple-choice questions. Assessment tool was in-vitro in artificial conditions as short case, long case. Setting of evaluation was removed from real site of job. No direct observation was made, and no formative feedback was provided. Evaluation was norm referenced. Emphasis was on summative evaluation. There was a fixed time for the components of the curriculum to be learnt. Program evaluation focused on matters of process (e.g., ''Are there objectives for every rotation?'' or ''Is there a teacher evaluation form?''). Most learners successfully completed their training by meeting time, process, and curricular requirements. When those requirements were met, the ability to apply what was learned to the actual delivery of patient care was assumed, without assessing whether the application of that learning to health care delivery occurred. When those requirements were met, the ability to apply what was learned to the actual delivery of patient care was assumed, without assessing whether the application of that learning to health care delivery occurred. Now the move is towards Constructivist model where Learner is an active participant in determining a learning plan. Stress is on Outcome-Knowledge acquisition. Educational strategy is Learner centered. Path of learning is Nonhierarchical. Responsibility for content is shared by the student and teacher. Learning is with reference to actual problems faced by professionals and thus contextual. Learning by students is active. Boundaries of disciplines are no more barriers and integrated curricula are being developed. Multiple objective measures for assessment ("evaluation portfolio") are being used. Assessment tool is in vivo. Work place based assessment like Mini clinical examination, Direct observation of procedural skills (DOPS), Case based discussions, and Acute care assessment tool are being utilized. Setting of evaluation is the work place. Direct observation, with formative feedback is in place. Evaluation is criterion referenced. Emphasis is on formative feedback. In contrast, competency-based training is based on the successful demonstration of the application of the specific knowledge, skills, and attitudes that are required for the practice of medicine. In support of Competency Based Medical Education, accreditation requirements have become Increasingly focused on outcomes. For instance, ACGME accredited Internal Medicine programs must now demonstrate evidence of data-driven improvements to the training program by using resident performance data, or outcomes, as a basis for improvement, and use external measures to verify both the learner's and the program's performance (ACGME 2009b). Similarly, all Royal College of Physicians and Surgeons of Canada programs require demonstration of both traditional time-based rotations and specialty-specific competencies (Accreditation Committee 2006). At the level of the individual stakeholder, the transition to a competency-based training model can represent a dramatic redefinition of professional identity.

A New Pathway For Medical Education

Health Affairs, 2013

Physician education in the United States must change to meet the primary care needs of a rapidly transforming health care delivery system. Yet medical schools continue to produce a disproportionate number of hospital-based specialists through a high-cost, time-intensive educational model. In response, the American Osteopathic Association and the American Association of Colleges of Osteopathic Medicine established a blue-ribbon commission to recommend changes needed to prepare primary care physicians for the evolving system. The commission recommends that medical schools, in collaboration with their graduate medical education partners, create a new education model that is based on achievement of competencies without a prescribed number of months of study and incorporates the knowledge and skills needed for a twentyfirst-century primary care practice. The course of study would occur within a longitudinal clinical training environment that allows for seamless transition from medical school through residency training.

Developments in medical education: Issues and responses

Health Policy and Education, 1983

The increase in scientific knowledge has led inexorably to the fragmentation of medicine and medical education. Doctors are trained to work and teach within their discipline. Managing the process of planning, implementing and evaluating teaching among the disciplines requires knowledge and skills in organization and management. The tasks are at the levels of the individual teachers, the department and the faculty, and of the committees they generate. The challenge for the individual teacher and of the organization is to coordinate their cooperative activities in the interest of the students and the promotion of health. Since no individual teacher is responsible for the whole organization, the central responsibility for this centripetal management lies with the Dean.

Medical education and the healthcare system--why does the curriculum need to be reformed?

BMC medicine, 2014

Medical education has been the subject of ongoing debate since the early 1900s. The core of the discussion is about the importance of scientific knowledge on biological understanding at the expense of its social and humanistic characteristics. Unfortunately, reforms to the medical curriculum are still based on a biological vision of the health-illness process. In order to respond to the current needs of society, which is education's main objective, the learning processes of physicians and their instruction must change once again. The priority is the concept of the health-illness process that is primarily social and cultural, into which the biological and psychological aspects are inserted. A new curriculum has been developed that addresses a comprehensive instruction of the biological, psychological, social, and cultural (historical) aspects of medicine, with opportunities for students to acquire leadership, teamwork, and communication skills in order to introduce improvements i...

Task Force Report 2. Report of the Task Force on Medical Education

The Annals of Family Medicine, 2004

BACKGROUND For family physicians to be prepared to deliver the core attributes and system services of family medicine in the future, especially within the New Model of family medicine that has been proposed, changes will need to be made in how family physicians are trained. This Future of Family Medicine task force report presents a plan for implementing appropriate changes in medical school and residency programs.

Reforming medical education: A review and synthesis of five critiques of medical practice

2010

For physicians to provide appropriate healthcare at a reasonable cost, health reform may not be enough. This essay discusses the scope of educational reform needed in the U.S. to train tomorrow's physicians to practice effectively in an increasingly complicated health care arena. We undertook a review and synthesis of five critiques of medical practice in the U.S.: of quality, evidence-based medicine, population medicine, health policy and heuristics. Our findings suggest that physicians are inadequately trained to function in the complex organizational and social systems that characterize modern practice. Successful health care reform in the U.S. will require physicians who are trained not only in bio-medicine, but also in the social sciences. Other developed countries, which have both greater government control of health care and a culture less oriented to individualism, may have less need for specific efforts to train physicians in the social sciences but could still benefit from considering an expanded curriculum. Effective educational reform must address the medical admissions process, academic and intellectual preparation, and professional and clinical training.