ANN ARBOR, Mich. — For 164 years, the University of Michigan Medical School has led the nation in innovative ways of training new physicians. Now, the school will take those efforts to a new level, after being awarded a $1.1 million grant from the American Medical Association in a national competition aimed at accelerating change in medical education.
As one of only 11 medical schools selected as winners by the AMA, U-M will use the funds to create a flexible new framework for medical students that will prepare them to lead change in health and health care in the dynamic global environment.
The resulting new curriculum will connect students directly with U-M’s clinical settings from the beginning of their training, working with other health professionals, and building a firm foundation of knowledge and skills. There will be an explicit focus on the development of leadership skills and professional identity, with the opportunity to unify the learning that happens in both medical school and residency training.
The winners were announced in advance of the AMA national meeting in Chicago on Friday. As U-M leaders develop and launch the new curriculum, they will take part in an AMA-led consortium of the other funded medical schools to ensure that best practices and innovations can be shared.
“The vision, creativity and dedication of our faculty have made Michigan an internationally recognized leader in medical education. As we revise our curriculum to best provide our students the educational foundation to become tomorrow's clinical and scientific leaders, this grant will provide financial resources and a national community of educators that will enhance the process,” says James O. Woolliscroft, M.D., dean of the U-M Medical School and Lyle C. Roll Professor of Medicine.
Over the next five years, as the curricular model is designed and phased in, the U-M medical student learning experience will become increasingly flexible, competency-based and oriented to the student’s interests, learning styles, and abilities. Students will be able to progress through aspects of the program at different rates, allowing them to master one phase of training, before proceeding to the next one.
A critical component of the model is the creation of the “M-Home”, a learning community that each student will be assigned to for his or her entire medical school career, connecting them to a team of faculty mentors, advisors, and clinical care settings that will foster their professional development.
“We need to bring medical education into the 21st century, where data-driven, team-based health care, grounded in science and quality, and informed by ethical, social and patient-centric factors, is the norm,” says Rajesh Mangrulkar, M.D., associate dean for medical student education, associate professor of Internal Medicine and Medical Education, and principal investigator of the proposal. “Our new curriculum will ensure we produce doctors who will be ready to lead changes in different aspects of health care that will have an impact on patients and their communities.”
From Flexner to flexible
Just over 100 years ago, a ground-breaking report by educator Abraham Flexner led to a transformation of American medical education, including higher standards and a scientific focus. Flexner singled out just five schools as models for the nation – including the U-M Medical School.
Then (as now), the fact that U-M owned its own hospitals with an integrated structure for all types of clinical care helped create an outstanding location for medical training.
Fast forward to this year, when the AMA launched its “Accelerating Change in Medical Education” competition to find new ways to bridge the growing gap between the way physicians are trained and the future needs of the health care system.
U-M’s proposal continues the school’s long tradition of emphasizing accountability throughout the learning process, and strong training in the scientific underpinnings of human disease. But it also adds greater flexibility in how students will progress and choose to focus on certain areas.
These include the specific skills and competencies they will need in their chosen area of practice through Professional Development tracks. This new curriculum will expose learners to the various specialties within medicine earlier, so they can make more informed choices about residency paths and other training or research paths they might wish to explore.
The proposal also provides all students the opportunity to develop leadership and change management skills, applying them in critical fields central to health care, such as Quality and Safety, Global Health and Health Disparities, and Bioethics.
The “Flexnerian” structure of two years of classroom training and two years of clinical training has already begun to blur at U-M, where students interact with patients and begin to practice clinical encounter skills beginning in the first year of medical school.
But the new curriculum will go even further to integrate the science and practice portions of training, and incorporate medical students into the inter-professional care teams that provide care for a wide variety of patients at the U-M Hospitals & Health Centers and the VA Ann Arbor Healthcare System.
Central to the flexibility of this program will be the measurement and tracking of learner and patient outcomes, important both for U-M and for schools that might wish to emulate the approach.
Sally Santen, M.D., Ph.D., assistant dean for educational research and quality Improvement and associate professor of Emergency Medicine and Medical Education, will lead the development of a rigorous assessment and program evaluation plan to measure, track, and analyze these outcomes and use it to shape each iteration of this curriculum.
For more information about the AMA initiative: http://www.ama-assn.org/sub/accelerating-change/index.shtml
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