Page 14 - Volume 69, Number 4
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L to R: Richard Burney, MD, Andrew Barnosky, DO, MPH, FACP, Rajesh Mangrulkar, MD.
General Session Summary
September 19, 2017
The Changing Face of Medical Education: An Era of Massive Critical Reform
By Richard E. Burney, MD
The University of Michigan Medical School undertook, beginning in 2012, a multiyear effort to bring about transformative change in its curriculum. U of M is one
of many leading schools across the country that have recently undertaken this challenge, and one of 11 chosen by the American Medical Association to receive support as part of the AMA program, Accelerating Change in Medical Education. While there has been broad general agreement that medical school education, both curri- culum and teaching methods, have long been outmod- ed, there is no consensus on what changes to make
and how to make them.
At the WCMS General Session On September 19, Rajesh Mangrulkar MD, Associate Professor of Medicine and Associate Dean for Medical Student Education at University of Michigan, addressed this important issue in his presentation on the “Changing Face of Medical Education: An Era of Massive Critical Reform: Why? How? What?”
He started by pointing out that bringing about change in one of the world’s strongest bastions of tradition
is not easy, nor is success guaranteed. Less massive, comprehensive efforts to reform the curriculum in 1998 and 2008 both ended in failure. This time would be different. First of all, it started with buy-in and support from all levels: top leadership (Vice Provost, Dean) department chairs, and faculty (by their vote to change school by-laws). Second, it worked from an evidence base: studies on “disruptive innovation,” and models for organizational change. It asked for and has depended on a high level of student engagement. Finally, it has accepted that this is an evolutionary, innovative process: it is not clear what the final product will exactly look like, but setting a vision and building a evolving program towards that vision remains the cornerstone of the effort.
First and second- year students are now fully engaged in the most mature form of the new curriculum.
The goals moving forward are to provide:
  In depth clinical training and exploration
  Opportunities to pursue professional interests and pursue one of several “paths of excellence” allowing exploration in depth
  Science learning integrated within clinical practice   Individualized development plans with more
flexibility under guidance
  Competency-based assessments
Moreover, emphasized throughout the new curriculum is the theme of leadership development, echoing the Michigan tradition of developing the Leaders and Best.
There are many unknowns, not the least of which is what Mangrulkar called the “assessment gap.” As the current controversies over maintenance of certification attest, there is no agreement about how best to assess competence. USMLE testing is necessary but far from sufficient.
Mangrulkar outlined and did not minimize the many challenges to overcome. If this effort is successful, perhaps the most critical final product will be the capacity to never again accept the status quo, but to continue to innovate flexibly in teaching, learning and assessment in a rapidly changing medical environment.
To learn more, go to medschool/education/md-program/curriculum
Washtenaw County Medical Society BULLETIN OCTOBER / NOVEMBER / DECEMBER 2017

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