Department of Medicine

What Society Needs from Medical Education

Keeping up with today’s evolving health care climate requires an outside the box approach to medical education. To be responsive to societal need for quality health care at lower cost, medical schools and residency programs will need to redesign how doctors are being trained. Arnold Milstein, MD, MPH,

arnold milstein

Arnold Milstein, MD, Director Stanford Clinical Excellence Center

is a professor of medicine, the director of the Stanford Clinical Excellence Research Center. He shares some innovative ideas on ways to train the next generation of physicians. 

How can we improve the training process?
Society needs physicians to more rapidly adopt known best practices and discover new best practices. This implies training physician in two new skills: 1) prompt clinical process change and 2) innovation development. These are not well represented in most undergraduate and graduate medical education programs.

Who can teach physicians on how to adopt or invent higher value care models?
This is an important opportunity for faculty from other disciplines to educate medical students and residents. For example, faculty from (1) organizational behavior and operations research at the business school; (2) human factor psychology and systems control from the engineering school. Equally important are social psychologists.

How can medical education better meet evolving societal needs?
The US medical education system needs a single coherent method for rapid appraisal of and adjustment to changing societal needs. The central appraisal question is: What are the ways physicians can contribute to the health related well being of society? Most important, such a coherent method would require an executive body with sufficient resources and authority to monitor and rapidly correct the mix and intensity of what students and residents are exposed to. It also would enable academic institutions to be more efficient and medical education to be more affordable by sharing educational resources and technology.

There needs to be a commitment by organizations that accredit medical schools and residencies. Currently, we have a very sluggish system for ascertaining what society needs and then altering medical education to respond.

What impact does medical education have on health care reform?
Health care reform is aimed at two goals. First, make sure that everyone can afford health insurance. The other element of reform is the ability to improve the health care system’s ability to lower the cost of health care while simultaneously improving quality. Medical education could be swiftly remolded to support these two objectives if those who accredit and deliver medical education wish to do so. 

 

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