In reflecting on the recent Association of American Medical Colleges (AAMC) annual meeting in San Francisco, I was impressed with the enthusiasm for reforming how we educate and prepare doctors, nurses, and other medical professionals for 21st century health care. It was great to see so many of the Macy Faculty Scholars and grantees at the AAMC meeting presenting papers, participating in workshops, or showcasing their projects.
Innovation was a key focus of the AAMC meeting and it was a real treat to hear Salman Khan, founder of the Khan Academy, discuss the power of online learning to “flip the classroom” and change the goals of student-faculty interaction. Khan started the Academy after successfully tutoring his niece and other family members in math. He gave up his day job as a hedge fund analyst to pursue this full-time, and today Khan Academy encompasses videos in many languages with hundreds of topics and millions of views. Khan shared his views on how to promote the same kind of learning tool he started in math and science to help health professionals learn more effectively and at their own pace. In fact, he is working with Stanford University to create and test online educational modules for medical students. It was fascinating to see what the future of medical education could look like as online learning becomes a more ingrained part of the educational experience.
At the meeting, I also participated in sessions focusing on preparing primary care physicians and the social mission of medical schools. I also attended a meeting of the Macy-funded New Medical Schools Consortium. With 16 new medical schools in the country, there is a lot of excitement around innovation in these institutions with spillover to the legacy schools. (For more information, read A Snapshot of the New and Developing Medical Schools in US and Canada, a Macy-funded publication from the AAMC).
Following the meeting I visited Palo Alto and participated in a think tank session with one of the exciting new champions of educational reform, the renowned health care economist Victor Fuchs. At last year’s AAMC meeting he issued an unusual challenge. After paying little attention to medical education before, Fuchs has become convinced that health system reform must be accompanied by a restructuring of medical education if our goal is to make health care more affordable and efficient.
Fuchs, a professor of economics, health research and policy at Stanford University and a prolific writer on the American health care system, is convening a group of thought leaders to talk about the need for new approaches to medical education. Among the topics discussed were shortening medical educational training, promoting a greater reliance on technology tools to build and assess competencies, and moving away from traditional clinical training to approaches more focused on teamwork, population health, and health care organization and delivery. He laid out his views in a recent post for The Health Care Blog. Many of these ideas are ones the Macy Foundation has been promoting and supporting and they are related to issues the Institute of Medicine will be studying as it prepares recommendations for improving graduate medical education.
Everyone realizes that the status quo is increasingly indefensible but how that gets expressed in the future will remain unclear. The reelection of President Obama means the Affordable Care Act will continue to be implemented, and this has broad implications for how health care is going to be organized, delivered, and paid for. It also is leading to a realization that we cannot reform the health care system unless we also pay attention to the education and skills of the health care workforce. The concept of merging medical education reform with health system reform is one we will be focusing on in 2013.