Medical educators' views on medical education reform

Article Abstract:

Criticisms of current medical education include the divergence between physician training and patient needs; focus on research and patient care at the expense of teaching; poor interaction between the basic sciences and clinical aspects of medical school training; lack of opportunity for students to monitor patients throughout the entire course of illness; and lack of emphasis on problem-solving skills, continued learning, and development of faculty role models. Reform of medical education has been particularly slow in American medical schools. It is not clear whether medical school deans, department chairpersons, and faculty perceive a need for reform and are willing to undergo a change in the medical education system. A national survey of US medical educators was conducted to determine their views on the perceived need for changes in undergraduate medical education, the nature of the proposed changes, and the willingness of institutions to adopt such changes. Reforms ranged from moderate changes in the curriculum to widespread restructuring of the management over the school's educational program. The factors that would enhance or prevent reforms in medical school education were also assessed. There were 1,369 respondents to the survey. Most educators, with the exception of basic sciences faculty, felt a need for fundamental changes in medical school education in the US. Almost 75 percent of deans and associate deans expressed a need for either fundamental changes or complete reform. Seventy-nine percent of educators supported six specific reforms, including rewards for teaching excellence and increased clinical education in outpatient and community settings. Reforms related to reducing class sizes or centralizing management were seen as less important. Widespread support would be essential for changes in the medical education system. These findings suggest that medical educators are not satisfied with the present system of medical education. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surveys, Medical school faculty, Medical teaching personnel

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Are we mortgaging the medical profession?

Article Abstract:

Upon graduation from medical school the average student owes $46,224, a burden that causes concern among medical educators and students, health policy makers and physicians. Financial aid takes the form of scholarships without practice obligations, scholarships with practice obligations (for example, through the National Health Service Corps or the military), and loans. The only two viable options are loans, and the Armed Forces Health Professions scholarships, for which there are six applicants for every award. Thus, the only real option for the great majority of students is to incur debt. Because physicians' earnings are high, it is often felt that this is unimportant. However, it affects the types of medical school applicants, the specialties they will choose, and where they will practice. The students with the most debt are most likely to be from low-income families and minority groups, and the expectation of huge debts may deter some candidates, at a time when the value of medicine as a profession is being debated. Faculty members sense that medical school is now looked at more as job training than as preparation for professional responsibility. At the same time, the high cost raises questions about the quality of medical education and the attention devoted by faculty. How much of the cost of a medical education should a student bear? Should the schools, since they derive only about 4.5 percent of their revenue from tuition, put a moratorium on tuition increases? Should tuition be abolished altogether? These and other questions should be considered. Among the most important questions is whether federal and state governments should reinstate a period of service so that doctors could meet the needs of the underserved population in exchange for free tuition. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Finance, Medical students, Medical education policy, Federal aid to medical education, Government aid to medical education

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Preparedness for practice: young physicians' views of their professional education

Article Abstract:

A large majority of physicians under 45 years old feel that their formal medical education prepared them well for their medical practice. A survey of 4,756 physicians asked them to rate various aspects of their medical training. General and family practitioners indicated they felt well prepared for many aspects of their practices. However, general internists did not feel equally well prepared. Only 3% of the physicians classified their training to handle the business aspects of their practice as excellent or good. Training to provide preventive care was rated as excellent or good by 60% of those surveyed. More than half of the doctors felt that they would have benefited from more time spent in managed care and long-term care settings. Many doctors did not feel that their training in coordinating patient care with community services was adequate.

Education, Physicians, Medical professions

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