opinion

AMA medical education grants: an idea whose time has come

A message to all physicians from Steven J. Stack, MD, chair of the AMA Board of Trustees, on the AMA's multimillion-dollar initiative to promote innovations in medical schools.

By Steven J. Stack, MD , an emergency medicine physician in Lexington, Ky., was chair of the AMA Board of Trustees during 2012-13. Posted Feb. 18, 2013.

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Sometimes all it takes is a nudge. In this case, of course, the nudge has been the AMA's $10 million in grants to finance promising innovations in medical education.

Nonetheless, it has been surprising — and very gratifying — to see the excitement our grant initiative has generated. Since we announced the program in mid-January, the Internet has been — if you'll pardon the expression — atwitter over the opportunity to develop proposals for game-changing education models that can be duplicated in medical schools across the country.

We all have known for quite a while that our current medical education system shortchanges students — not because they don't get a good education, but because it trains them for a world that has been passed by.

Our present system was developed when a four-year education pretty much could teach a medical student everything he or she would need to know to practice medicine. Yet today we live and work in a world where we have identified more than 13,600 different diagnoses for what may ail our patients. We have 4,000 medical and surgical procedures to remedy those problems, along with more than 6,000 drug options to reduce suffering, extend lives and sometimes stop a disease altogether.

In short, science, technology and the art of medicine have outstripped the way we train doctors. As a result, patients and physicians both lose out.

For at least a decade, the AMA and members of the medical community have talked about the need to change medical education. The AMA has sponsored studies and gathered leading medical educators together to find a path forward. And it's not that the ideas haven't been out there. Many of our leading medical schools have made incremental improvements but, overall, the fundamental structure of medical education has not changed. Cost and the risk of being “too different” have been limiting factors.

It is now plainly clear that incremental steps won't be enough. We need to transform a student's education from one that focuses on a single professional's individual practice to one that teaches physicians how to work both as leaders of and members of teams. There must be lessons on the “business” as well as on the art and science of medicine. We must prepare physicians for an ever-more diverse patient population and a rapidly changing health system.

When it became clear that the challenge we face is to revolutionize medical education, the AMA saw that to make a difference, we would have to do something revolutionary ourselves — something noteworthy enough to attract the attention of the entire medical community and substantial enough to make a solid contribution to the future.

In other words, if we wanted to see momentous changes in medical education in the near future, we had to put our money where our mouth is.

To begin, we launched our announcement at a multi-medical school student engagement event with a live broadcast. Within a week, the story had been covered by a wide variety of news and medical publications — ranging from Modern Physician to Forbes and Bloomberg Businessweek — and taken on a life of its own. More than five times more people saw the announcement on Facebook than we generally expect in a week, and it was seen or forwarded on Twitter accounts with more than 800,000 followers.

I believe that one reason for the excitement is that we all — practicing physicians, medical educators and medical students — realize that it's past time to pursue a new course. It is no longer possible to put off the task, or to accept minor changes.

Interestingly, medical schools have expressed a great deal of the enthusiasm for one specific activity of the AMA grants initiative: the formation of a multi-school consortium for the selected schools. The AMA will establish the consortium so the schools involved can work together, learn from each other, have a common evaluation plan and share the results with the rest of the medical education community.

We also are confident that these initiatives will continue to have an impact well into the future. The Liaison Committee on Medical Education has begun a review of medical education standards with an eye to confirming what is timely and relevant and then changing what is not. And the Accreditation Council for Graduate Medical Education already is making changes: Last year they updated residency standards to include stronger focus on things like patient safety and team-based care. So the national organizations that support and accredit medical education are putting new mechanisms in place now that will make it easier to accept and implement visionary new ideas.

Giving institutions the ability to jump-start significant changes in medical education turned out to be more than just a good idea. We have been inundated with preliminary proposals from across the spectrum of American medical schools. And I am convinced that when the awardees are announced in June that the exuberance we have felt in the past few weeks will even ratchet up a notch or two.

Of course the reason for an open call for proposals has not been just to make awards. By providing a competition, we hoped to generate a wealth of sound innovative ideas that will serve to transform medical education even beyond the work of the eight to 10 selected grant recipients.

In addition to the schools that will receive the AMA grants and form the learning consortium, we plan to explore opportunities to fund additional promising ideas. The enthusiastic response to the request for proposals uncovered several promising ideas, and the AMA will explore opportunities to seek out others who can join us in partnering and funding some of the other excellent proposals not selected for the first round of funding.

Stay tuned: This is an exciting time! If you would like more information about the AMA $10 million grant program to transform medical education, learn about the national advisory panel, or watch a short video, information is online (link) .

I am convinced that when we announce the recipients of the AMA grants in June, you will be able to see the beginnings of a whole new approach to medical education — one whose time has finally come.

Steven J. Stack, MD , an emergency medicine physician in Lexington, Ky., was chair of the AMA Board of Trustees during 2012-13.

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