A key measure for any foundation is whether the work it supports is having impact or influencing change in its area of focus. I recently returned from Denver, CO, where I attended the Association of American Medical Colleges (AAMC) annual meeting, something I do every year. This year I was particularly struck by how much of the work we support is permeating discussions about academic medicine reform. Let me share three examples:
AAMC President Darrell Kirch’s address [pdf] challenged medical schools to seek a “new excellence,” urging academic leaders to steer away from traditional measures for ones that align more with health care today. Dr. Kirch’s speech touched on many ideas we support and have been advancing, including diversifying medical school applicants, promoting interprofessional teams, integrating technology to enhance learning, and aligning research and education to improve quality and safety. His call for medical schools to embrace broader measures of excellence beyond size, growth, or reputation—historical benchmarks that he said “distract us from our true mission” – is an idea we raised in 2009 via a Macy-funded report produced by Dr. Fitzhugh Mullan. “The Social Mission of Medical Education: Ranking the Schools,” available here, drew both praise and criticism from the field for examining the extent to which medical schools were meeting their so-called social mission, ranking schools on atypical measures such as their ability to graduate physicians who practice in primary care, work in underserved areas, and who represent minorities. Dr. Kirch seemed to be taking a page from that report, telling academic leaders that they should be judging their schools performance or quest for excellence, not just by rankings, but how well research and education efforts lead to overall improvement in health and how well schools serve and meet the needs of communities at their front doors.
Another area where are efforts were reflected was in a presentation relating to graduate medical education. Well known Stanford University economist and health policy expert Dr. Victor Fuchs, raised the idea of reducing the duration of training for physician residents, a proposal we included in our 2011 GME report “Ensuring an Effective Physician Workforce for the United States: Recommendations for Reforming Graduate Medical Education to Meet the Needs of the Public,” available here. Although his recommendations went a bit further than ours, it is heartening to see that the field is publically debating whether there is merit to retaining the current system of training all residents for a fixed duration or whether it would be better to base it on their readiness for practice.
Finally, Macy grantee Prathibha Varkey, an associate professor of medicine at the Mayo Clinic College of Medicine, had the great honor of delivering the John A.D. Cooper Lecture, a well-attended session that raises important issues in medical education. Dr. Varkey ‘s well-received presentation on the importance of teaching quality and safety as subjects in medical school was derived in part from a Macy grant “Improving Patient Care through Education: The Mayo Clinic Quality and Safety Initiative,” about which you can read more here.
These examples, along with the presence of many sessions on Interprofessional Education, teamwork, new-models-for-clinical-education, GME reform and the importance of diversity, are evidence of the foundation’s influence. It’s great to see how much the work we support through our grantees and conferences is not only having impact but shaping conversations that will lead to efforts to improve the education of health professionals as well as foster better care for patients.