At an all-day conference Monday, representatives from 11 medical schools from around the nation came together at the University to discuss the future of medical training in the face of a rapidly evolving healthcare system.
The American Medical Association assembled the convention as part of an initiative called “Accelerating Change in Medical Education,” a competition challenging schools to create their best proposal for innovative medical training. With nearly every medical school in the country participating, the University’s plan was one of the 11 chosen by the AMA. Each winning college received a $1 million grant to implement their proposal over five years.
Susan Skochelak, AMA group vice president for medical education, said though each school will implement its own plan, there will be regular communication between institutions. She said the AMA hopes the best practices will spread to medical schools throughout the nation.
“What’s happening with these 11 schools is they’re really trying out new prototypes,” Skochelak said. “They’re sharing and learning with each other so that one school on its own doesn’t have to reinvent the wheel.”
Rajesh Mangrulkar, associate dean for medical student education, said the University’s plan involves restructuring medical education to ensure each student gains vital knowledge and abilities within their first two years of school. Currently, he said students do not gain this core information until they’re about 75 to 85 percent into their education. For the latter half of medical school, students will focus on their intended specialty.
“Consolidating that core then allows the student to enter into professional development branches,” Mangrulkar said. “They can really deliberately dive into areas of medicine they are most interested in and can envision a career in.”
The University’s plan will also emphasize leadership skills. Every student will be assigned into an “M Home,” a type of learning community. These groups will provide coaching, advising and mentorship over the course of each student’s education.
Because the long-term effects of the Patient Protection and Affordable Care Act on the U.S. healthcare system remain largely unknown. Mangrulkar said doctors-in-training must be prepared for unexpected hurdles.
“At Michigan, we believe every graduate should be a problem solver, who could then walk into that environment and be able to say, ‘alright, this is what’s working, this is how we need to do things differently,’ ” he said. “Right now I just don’t think we have that in our medical schools.”
From the start, a main concern associated with ACA implementation was an increased patient volume. This could lead to a shortage of doctors or increased wait times as seen in the similarly-structured Massachusetts healthcare reform package of 2006.
Mangrulkar said the University’s plan would allow certain students who demonstrate exceptional ability to graduate early.
Skochelak said there should be increased flexibility in the time doctors must spend in training.
“If you think about it, nowadays many students are coming (to medical schools) that aren’t right out of pre-med,” Skochelak said. “If you’re a physical therapist or a biomedical engineer and then you apply to medical school, you don’t have to take the exact same four years … It’s less about shortening it and more about making sure people can move along when they’re ready to move.”
The changes will also alter the admissions and residency process. Mangrulkar said the Medical School seeks students who will develop into problem solvers as well as “change-agents.”
“We’re in the process of relooking at everything, including admissions,” he said.
As for residency, Skochelak said Graduate Medical Education is amending the residency process to better fit the changing landscape of medicine.
“There are already a few pilot projects where residency starts earlier,” she said. “They also have to find ways to be more flexible, just like the medical school curriculum is getting more flexible. We know it has to change, it’s a big job though.”