The future of medical school education – “creating leaders of change”

Dr. Clay Johnston, dean, Dell Medical School: soft smile belies bold mission

Yesterday, The New England Journal of Medicine published an article entitled “Innovation in Medical Education.” http://www.nejm.org/doi/full/10.1056/NEJMp1407463 Similarly, last fall, the American Medical Association rolled out a plan to introduce “innovation” to medical school education.

What are the issues and how will new paths be forged?

I had the opportunity to speak with the dean of America’s newest medical school to learn more about these issues first-hand. In this piece I cover his perspective on the issue, and review points raised in the medical community publications cited above.

Dr. Clay Johnston, Dell Medical School, University of Texas, founding dean, summarized the overarching problem he will be addressing in his new role:  “Doctors have often resisted change even in the face of a healthcare system begging for improvement.” To that end, he continued, “we’ve got to make anticipating and shaping the future a part of the core mindset of future physicians.  Rather than being the ones resisting change, or even reluctantly accepting new approaches from other sources, doctors need to be trained to proactively drive the change needed in our industry.”

American Medical Association (AMA) Approach

Last fall, the American Medical Association (AMA) hosted a pivotal meeting to initiate the transformation of medical education in the U.S.

http://www.ama-assn.org/ams/pub/meded/2013-october/2013-october.shtml

The AMA proposes four new initiatives to update their educational system to create an openness to transformation within their ranks. These include:

• Competency-based curriculum

• Technology-enhanced learning

• Team-based training/ integrating education across medical professions

• Greater focus on prevention and chronic diseases

The New England Journal of Medicine: “Innovation in Medical Education” proposal

The authors recommended three changes in medical school education:

1. Establishing metrics for success in the goal of  “the production of a workforce capable of delivering economically sustainable care that will improve the health of patients and populations in a changing environment”

2. Examining fundamental changes to the structure of medical education, such as whether graduation should be time-based or competency-based;

3. Piloting new models for financing medical education. As it stands today, they say “Currently Medicare (mostly) pays hospitals (mostly) for training residents (exclusively physicians), using a historical formula that is largely untethered to current goals.”

Trends to watch

Hopefully, as the AMA and other stakeholders roll out new initiatives, they will keep their eye on the overarching purpose of these mechanisms, as articulated by Dr. Johnston – “creating leaders of change in medicine.”

Tracking and replicating success among new institutions, such as Dell, in addition to other schools that have established a reputation for leading new initiatives, will be essential.

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For those interested in hearing Dr. Johnston’s vision for change, scroll ahead to the last four minutes of this video presentation. http://www.youtube.com/watch?v=R1Hf8Dar1IQ