Changes in Medical Education -- 50
Years Ago,
Today and Tomorrow
Looking Back and Ahead
CONGRATULATIONS TO OUR NEW
MEMBERS
• “ There are two kinds of people; those who do
the work and those who take the credit. Try to
be in the first group; there is less competition
there.” – Indira Gandhi
GOALS OF THE ACADEMY OF MASTER
EDUCATORS
• RECOGNIZE AND REWARD OUTSTANDING
EDUCATORS
• Support faculty development for education
• Promote the academic advancement of educators
• ENCOURAGE IMPLEMENTATION OF INNOVATIVE
EDUCATIONAL PROJECTS
• Promote curriculum design and reform;
• Foster educational scholarship and research
In this talk I aim to ……
• Reflect on medical education when I was in
medical school
• Contrast my experience with our current
educational program
• Think about medical education of the future
• Provide a few ideas for innovations in hopes that
they will stimulate you to -• Develop your own ideas and help put them into
practice working through your Academy
Think
back
to
1951
TIME MAGAZINE
July 16, 1951
Korean War continues
Harry Truman was President
Will there be a polio epidemic in 1951? The National Foundation
for Infantile Paralysis said the U.S. must raise its idea of
“normal” polio incidence from about 10,000 a year to perhaps
30,000”. (Actually 28,000 new cases were reported.)
Freshman Class at UTSW, 1950
8
Freshman Class at UTSW, 1950
10
Freshman Class at UTSW, 1950
12
Freshman Class at UTSW, 1950
14
Medical Education 50 Years Ago and
Now
Then
Now
• Fewer lectures – streaming!
• Lectures all morning , six
• Fewer laboratories
days a week
• Laboratories all afternoon , • Clinical approach to basic
(only 4 days a week)
sciences
including “dog labs” as well • Several small group sessions
as anatomy, biochemistry
• Problem-based learning
and others
• No clinical experiences until • Team based learning
physical diagnosis at end of • Introduction to Clinical
2nd year
Medicine
Medical Education 50 Years Ago and
Now
THEN
• Long clinical rotations
filling 3rd and 4th years
(e.g. 5 months of
Medicine in the 3rd year
• More direct hands-on
experiences such as first
assistant at surgeries
• No electives
• Summer vacations
NOW
• Evidence based medicine
• Standardized patients and
simulations
• Scholarly concentrations
• Emphasis on competence
• Shorter required clinical
rotations
• Many electives including
one in 3rd year
“New Flexner Report” 101 Years Later
General Recommendations
1. Standardize learning outcomes but
individualize processes
2. Provide early clinical immersion and later
revisiting of the basic sciences
3. Develop habits of inquiry and selfimprovement
4. Address professional identity formation
explicitly
(Cooke, Irby and O’Brien)
Some Possible Ways for the Academy
to Support Expanded and New
Educational Efforts
PARTICIPATION IN ONGOING EFFORTS
Curriculum Integration
A. Students are the only ones who know our
educational program in detail. Develop a
presentation to inform faculty about the content
of our curriculum
B. Curriculum mapping (see Len Cleary)
C. Fostering interactions between pre- clerkship
courses and clinical years
Participation in Ongoing Efforts (cont.)
Support scholarly concentrations. Increase the
number of them; assist the faculty in
developing appropriate learning objectives.
Develop a scholarly concentration in medical
education. (MU)
Provide your own ideas about how you can
support these ongoing educational efforts
DEVELOP BRAND NEW INITIATIVES
“Every really new idea looks crazy at first” Alfred
North Whitehead
_______________________________________
Develop a longitudinal clinical experience
throughout the four years . For example
students follow a family from matriculation
until graduation
Innovations (continued)
Imagine (and implement) an educational
program with no or few lectures(JMcM)
Encourage students to develop pathophysiology
learning modules centered on real patient
problems(JMcM)
Innovations (continued)
• Following the lead of other medical schools
develop 4 to 8 student academic societies to
provide a smaller community where everyone
feels heard. These societies could provide
academic and personal advising, career
planning and a social unit.
Innovations (continued)
Evaluate and improve the teaching of evidencebased care :
Determine and assure the appropriate use of
the electronic medical record by students
Assess the educational advantages and
disadvantages of computerized decision
support systems
Innovations (continued)
Define and explore the role of “critical thinking’
in medical education
It’s a hot topic in medical education and is the
has been a topic of a recent Millenium
Conference sponsored by the AAMC and the
Shapiro Institute in Boston
One Definition: “Doctors thinking about how
doctors think using the formal approaches of
logic”
Innovations(concluded for now)
MOST IMPORTANTLY: Develop and share your
own ideas.
HINT
“The best way to have a good idea is to have a
lot of ideas and throw the bad ones away”
--Linus Pauling
What next?
Join with other members of the Academy to
share your ideas and develop ways to
implement them.
Contact Margaret Uthman who chairs the
Development Committee or Gary Rosenfeld
our President to find out how the Academy
can help implement your ideas.