Report Examines Challenges and Lessons Learned Among 15 Allopathic Schools
A new report released today highlights the motivating factors, challenges, and planning strategies faced by 15 of the newest U.S. medical schools and offers important lessons learned as they begin to enroll classes and implement academic programs. The report, commissioned by the Josiah Macy Jr. Foundation, provides an update on eight of the new medical schools, which were showcased in a 2009 report, and describes in detail the circumstances that led to the development of seven additional schools.
The 15 new medical schools were launched in response to growing evidence that the United States was facing a significant shortage of doctors in some specialties and regions of the country. In 2000, Florida State University established the first new medical school in the United States in 20 years. However, in 2006, the Association of American Medical Colleges called for a 30-percent increase in medical school enrollment to address a persistent shortage of physicians. That AAMC recommendation offered a rationale for not only expanding class size but also creating additional medical schools.
Fourteen of the schools will have enrolled their charter classes by September 2013 and one will do it in 2014. Four schools graduated their charter classes this year. By the end of 2020, these 15 new schools expect to be graduating 1,800 students every year, a step that would contribute about one-third of the additional graduates needed to fill the provider gap.
“It’s too early to tell how the schools will fare on preparing students for the new health system, whether they will increase the number of graduate medical education positions in the country’s GME enterprise, or how successful they will be in terms of developing robust research programs,” says report author Michael Whitcomb, MD, Flinn Visiting Scholar at the University of Arizona College of Medicine-Phoenix. Nevertheless, Whitcomb says the early experiences of these schools offer important information for other institutions considering following suit.
With the rollout of the Affordable Care Act and the push for more coordinated, affordable, and greatly improved health care quality, “showcasing these creation stories comes at a critical time,” says Macy President George Thibault, MD. “These new schools have the opportunity to be laboratories for innovations in admissions, curriculum, pedagogy, faculty development, and community engagement and could yield positive benefits for community and medical education in general,” he adds.
The report looks at the major challenges institutions interested in starting a new medical school face. These include financing the school’s operating costs; acquiring the space and facilities required to meet student and curriculum needs; and developing clinical affiliations that will allow the school to provide the right kind of clinical education experiences for students.
Key lessons learned:
- Most of the new schools had an important relationship with a state university.
- In several cases, the names of the healthcare institutions that supported the development of the schools are included as part of the school’s official name.
- The introduction of small group learning experiences, simulation exercises, and standardized patient encounters has had a major impact on the kind of space required for the educational program. Schools have less need for large gross anatomy labs to support basic science and the evolution of online reference materials has made it less important to maintain a standard medical library. Space instead must be available to provide students access to computers and to allow them to engage in independent or small group study.
None of the new schools could have been established without the support of one or more local healthcare institutions. But some of the newer schools were challenged to identify healthcare institutions that could serve as adequate sites for the clinical education of their students, including providing adequate experience for students in several of the core disciplines for accreditation purposes. Schools found it even more challenging to provide the experiences in institutions where students would have the opportunity to interact with medical residents. Several of the schools have found it necessary to rotate students through a number of healthcare institutions.
Whitcomb says it is inevitable that major hospitals and health care systems will continue to play a role in the development of new medical schools in the United States. However, he adds that those interested in starting a new school should focus their initial efforts on identifying a clinical affiliate that is willing and able to be a major partner in development. New schools are learning that the most effective clinical partners are health systems that already sponsor graduate medical education and are already involved in educating medical students. The continued evolution of regional branch campus programs by medical schools is another trend that will likely play an important role in the development of new schools in the future, he adds.
The report “New and Developing Medical Schools, Motivating Factors, Major Challenges, Planning Strategies, Part 2” is available here.
About the Josiah Macy Jr. Foundation
The Josiah Macy Jr. Foundation is the only national foundation solely dedicated to improving the health of the public by advancing the education and training of health professionals. Since 1930, the Josiah Macy Jr. Foundation has worked toward its mission of improving health care in the United States. Follow us on Twitter and learn more at www.macyfoundation.org.