Rethinking physicians' training in chronic disease management

Ten medical schools are developing curricula and will offer classes in the fall.

By Bonnie Booth, AMNews correspondent. Feb. 26, 2007.

Most experts agree that medical education needs a major revision so that future physicians are best able to treat the millions of patients expected to be living with chronic diseases in the foreseeable future.

The system under which medical students are educated and trained continues to be geared toward providing acute care in a hospital setting -- an outdated model when more and more care involves managing chronic conditions in an outpatient setting.

"At present, medical education is based on an acute care model in which patients are examined, diagnosed, treated and released," said David C. Thomas, MD, associate professor of medicine and medical director of the division of general internal medicine at Mt. Sinai School of Medicine in New York. "Chronic illness is much more longitudinal. That's not a culture that physicians have grown up in. Now doctors need to gather much more information from their patients and then partner with them."

Mt. Sinai is one of 10 medical schools to which the Assn. of American Medical Colleges awarded grant money to figure out the best way to shift the focus of medical education to chronic disease management in doctors' offices and clinics.

At the start of the 2006-07 academic year, each school received grants totaling $100,000 over two years, the AAMC said. The first year is reserved for planning. In the second year, the schools will implement curriculum changes. Funding for changes in residency programs has been issued to nine institutions, which each received a $75,000 one-year planning grant. One of the 10 schools does not have a residency program.