This Month's News
"We think this is the tipping point"—A year of accelerating change in medical education
A year after its launch, the AMA's Accelerating Change in Medical Education initiative has exceeded expectations in leading partnerships to transform medical education. In the four months since the grant awards began, the AMA's 11 partner schools are implementing new ideas and working together - eager to spread innovation.
"We know that physicians' roles are evolving and we must anticipate the needs for physician training in the next 20 years," said Susan Skochelak, MD, group vice president for medical education at the AMA. "The questions are, in 20 years: What are the components of the medical school of the future? How does it function? What does it look like? How do you learn?"
To answer those questions, the AMA announced last January its intent to fund five to 10 medical schools to implement bold innovations in medical education. The quality of the proposals submitted by the medical schools was impressively high, and the AMA chose to fund 11 schools, each receiving a $1 million grant over five years to accelerate change.
A "tsunami of interest"
Last January, AMA Executive Vice President and CEO James Madara, MD, announced to deans, faculty, AMA leaders and students that the AMA was seeking proposals from allopathic medical schools in the United States for innovative projects for redesigning undergraduate medical education.
In addition to seeking innovative and creative projects, the Accelerating Change in Medical Education initiative planned for the partner schools to form a consortium to share ideas, discuss outcomes and plan for wide dissemination of innovative models. In an overwhelming show of interest, more than 80 percent of eligible medical schools submitted proposals, a clear sign that medical schools are ready to implement transformative changes.
"There appears to be a tsunami of interest in changing and enhancing medical education coming from the medical schools," said Dr. Skochelak. "They want to implement these ideas, but they face barriers that are extremely difficult to overcome. If it was easy, they'd be doing it. If we can partner with the schools to break open the constraints and lower the barriers, the opportunity for significant transformation is achievable."
After thorough internal and external review, the announcement of the 11 selected medical schools was made during the AMA Annual Meeting in June. By selecting 11 schools rather than the planned five-10, AMA chose to increase its total grant funding to $11 million based on the strength of the ideas submitted.
"There were people waiting in the wings for this," said George Mejicano, MD (pictured below), senior associate dean for education at Oregon Health and Science University School of Medicine. "We think this is the tipping point …. We were committed to making the changes [in our program,] but our vision was much bigger than our resources. The grant got us over the hump."
A "responsibility to spread this"
Grant recipient schools began their projects in September. Most schools now are in the planning stages, and true implementation will begin this fall. The schools already are sharing new ideas and methods with one another through the initiative's consortium, which first convened in October at the AMA's Accelerating Change in Medical Education Conference in Chicago. The school teams were able to share, learn and plan with their peers at other institutions.
The participating schools are focused on a range of projects that include such components as competency-based assessments, individualized learning plans and progression to the MD degree, new roles for students within their health care systems and use of new technology to assist learning.
"The Accelerating Change in Medical Education initiative has prompted the participant schools to take some educational risks and try new models that are more in line with the needs of today's medical students," said David Savage, a fifth-year MD/PhD student at the University of Texas Medical School in Houston and a member of the initiative's National Advisory Panel. "Students have a great sense of the problems facing health care systems. They are also eager to find solutions, have time to do so and are not yet jaded by the frustrations of those systems."
These risks are exciting but also a bit daunting, said Dr. Mejicano.
"[T]he grant has given us the validation and resources to take a gigantic leap forward, and now we have to actually build this thing," he said.
But the benefits highly outweigh the trepidation that some may have for change, said Dr. Skochelak.
Rapid developments in changing medical education
"We are pleased with the rapid development of new pathways to advance changes in physician education," Dr. Skochelak said. "We thought our 2013 goals were bold … but we see that the AMA can leverage our leadership opportunities and set our 2014 targets significantly beyond what we expected.
Above all, the AMA initiative has revealed that medical education is ready for transformation, not just within schools and programs but across the entire system. Changes that schools are making will affect the complex medical education and accreditation systems, said Dr. Skochelak, and the AMA is beginning to focus on some of these larger challenges.
"If only 11 schools change, that's not going to be enough," said Dr. Mejicano. "There is a responsibility on us. Not only do we have to change and rigorously evaluate the outcomes of the projects, but we also have a responsibility to spread this. That is incredibly exciting."