'More Than Just Facts': The Future of Medical Education

Sheri Sellmeyer


December 02, 2016

Medical education in the United States underwent dramatic change a century ago by focusing on rigorous training in basic and clinical science. Now, the American Medical Association (AMA) is adding a third discipline, introducing a textbook on health systems science.

The textbook, available in December, aims to help medical students understand how health systems work and how to deliver value-based care. Health Systems Science is part of the AMA's initiative to create the "medical school of the future." It reflects the work of the AMA and 11 medical schools that are part of its Accelerating Change in Medical Education Consortium.

Although US medical schools are rigorous in teaching basic and clinical sciences, they have lagged behind in training students how healthcare systems work. "When I was in medical school, many graduated not knowing the difference between Medicaid and Medicare," says Susan Skochelak, MD, the AMA's vice-president for medical education outcomes.

The idea behind Health Systems Science is that physicians must understand the effect of informatics, population health management, and healthcare economics to effectively deliver care.

Some of the schools in the consortium are already teaching health systems science in their curricula. Mark Schwartz, MD, professor of population health and vice-chair for education and faculty affairs at NYU School of Medicine, is among the authors of the new textbook. Traditionally, Dr Schwartz said, "We do an excellent job of teaching clinical reasoning—responding to a set of facts about the patient. But to wrap your head around population health metrics is a different skill set."

NYU has created a "Health Care by the Numbers" curriculum to teach students about population health management. The program uses virtual patient panels from deidentified patient data and open data sources. The school has recently begun panel discussions with representatives of several hospitals in which they respond to students' questions about the patient populations. "They ask about differences in length of stay, cost of care, differences in payer mix, and how patients end up in one hospital or another," said Dr Schwartz. "Their questions are quite basic but profound."

This emphasis on patient population management extends beyond the classroom. Much of NYU's curriculum is delivered through iPads issued to students when they start medical school. Once they begin clinical rotations, they use software that allows them to track the range of patients and disorders they're seeing.


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