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Bold changes urged in med training


By Andis Robeznieks
Posted: February 23, 2009 - 12:01 am ET
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Expansion is going on at almost all the medical schools in the U.S., and this is expected to increase the physician population by some 5,000 new doctors by 2020.

According to a new report, medical educators should look at this expansion as an opportunity “to explore bold, innovative ways to improve” medical education, including better alignment of medical training with societal needs and incorporation of “contemporary realities,” such as the rapid pace of scientific discovery, calls for more public accountability, acknowledging the unsustainable cost of healthcare as well as “unconscionable” racial and ethnic disparities, and the increasing burden of chronic illness and disability.

The report, Revisiting the Medical School Educational Mission at a Time of Expansion, summarizes a discussion that took place between the 36 participants at a conference held this past October in Charleston, S.C. The conference and report were sponsored by the Josiah Macy Jr. Foundation, a private philanthropic organization that aims to advance healthcare training and education.

Participants focused on issues such as how educational debt shapes career and practice choices, and the “conspicuous gap” between the high professional standards called for in the classroom and the behavior on display in clinical environments.

Recommendations in the report include reorganizing the curriculum so graduation requirements could be met in three years rather than four to reduce debt, fostering teamwork and better dissemination of information about innovative programs, and “ensuring that all medical students retain their enthusiasm for medicine and remain committed to its societal missions.”

During a news conference, Jordan Cohen, M.D., co-chairman of the Macy conference and former president of the Association of American Medical Colleges, said that the overarching message of the report and conference is that medical schools must accelerate their rate of change and generally “unleash their creativity.”

One way to do this, Cohen suggested, was to “look beyond academic measures” when choosing medical students and to also take in account candidates’ maturity and commitment to serving others. He also called on students to “take more responsibility for their learning” and to design their own schedules and seek out what they need to know to achieve their educational objectives.

In other medical education news, the University of Minnesota Medical School is searching for a new permanent top leader following an administrative reshuffling that left the current dean, Deborah Powell, M.D., without a job.

University President Robert Bruininks announced that the school’s two top jobs—those of the dean and the senior vice president for health sciences—were being combined into one role. Bruininks said in a letter to university staff that the streamlining follows a pattern seen at other medical schools nationally.

Frank Cerra, M.D., the sitting health sciences senior vice president, will assume Powell’s job responsibilities by July 1 if he is appointed to the interim dual role by the university’s Board of Regents in May. University officials expect to begin a nationwide search next year, with the goal of finding a permanent top administrator by the fall of 2010.

Powell is in ongoing discussions with university officials concerning an administrative position in medical education, a news release says. She was the first female dean of the 154-year-old school. Powell was the subject of a critical Dec. 21, 2008, article in the Minneapolis Star-Tribune that said she had appointed university professor Leo Furcht, M.D., to a medical school ethics panel, even though Furcht was sanctioned in 2004 for secretly steering a $501,000 research grant to his own company.



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