2018 Annual Report: Improving Health Professions Education

Medical and nursing schools across the country are taking steps to embrace competency-based, time-variable education—a system where students advance only after mastery of required competencies and skills, rather than after a fixed period of time. To help understand what it will take to speed up this shift, the Macy Foundation supported the Academic Medicine supplement, “Competency-Based, Time-Variable Education in the Health Professions,” which explored how to design and implement an education system in which students advance at their own pace, as they master specific concepts and skills.

Patient care is based on a relationship of trust where society grants the profession the privilege of self-regulation and in turn expects the highest level of competence from its health care professionals. In September 2017, we convened grantees from our Educating and Training to Professionalism Initiative to explore what it will take to instill and cultivate the highest standards of professionalism throughout the medical education process and into a lifelong career as a medical professional. We captured these insights, along with lessons learned from the five-year initiative which was launched in partnership with the Institute on Medicine as a Profession, in our report Educating and Training to Professionalism.

Twenty-one new medical schools have enrolled students since 2006, when the AAMC called for an increase in U.S. medical school enrollment. The early experiences of these schools offer important information for other institutions that are considering following suit. In 2009 we commissioned a series of publications to examine the motivating factors, challenges, and planning strategies faced by the newest U.S. medical schools. We released the latest installment, New and Developing Medical Schools: Motivating Factors, Major Challenges, Planning Strategies Part 3, which reported on the six newest schools, in April 2018.

Health professionals want their education and work to be meaningful, stimulating, empowering, collaborative, and respectful. Yet too many experience the opposite: high levels of depression and burnout as well as distress, marginalization or exclusion. Last summer we issued the recommendations from the conference on Improving Environments for Learning in the Health Professions to guide leaders from health professions education and health care organizations on how to design and create optimal learning and work environments for students, teachers, and clinicians—environments that ultimately contribute to better patient outcomes.

To bring about meaningful and lasting change in health professions education, we need to invest in the people who can make it happen. Mid-career faculty members are among the best change agents. In 2018 we welcomed our eighth cohort of Macy Faculty Scholars who are now implementing educational change at institutions across the country. To help other funders see the value of investing in people, former president George E. Thibault, MD penned “Producing Change Agents: How One Foundation Is Transforming Health Care” for the Chronicle of Philanthropy.

After ten years at the helm, George E. Thibault, MD stepped down as president of the Josiah Macy Jr. Foundation in June 2018. The Macy Foundation honored Dr. Thibault’s legacy in health professions education by endowing the George E. Thibault Academy Professorship at Harvard Medical School.

“One of the most meaningful things we have in academia is an endowed chair for a beloved mentor whose name can ripple through the generations because of the impact they’ve had and continue to have through their mentees.” -- Edward M. Hundert, MD, Dean for Medical Education at Harvard Medical School