Dear Colleague,
Last May I wrote a Code Blue article1 describing the American Medical Association's (AMA's) Initiative to Transform Medical Education (ITME), a project that aims at promoting excellence in patient care by reforming the medical education and training system to meet the needs of the changing healthcare system. ITME has taken significant steps toward accomplishing this goal, and I would like to update you regarding the process and review the next steps.
As you may recall, the core principle underlying ITME is that safe, quality medical care is dependent upon a well-educated, diverse physician workforce that is prepared to meet the challenges of the healthcare system for the greater benefit of all patients and society. Put more simply, our system of medical education must undergo a transformation in order to meet the needs of the ever-changing healthcare system.
Phase 1
The first phase of ITME began with a conference held in December 2005, in which key representatives from consumer groups and the public, healthcare providers, payers/ purchasers, policy makers, medical educators, and members of the accreditation, certification, and licensure communities convened in Chicago. For a day and a half, participants worked together to identify strengths and gaps in the preparation of physicians regarding their ability to interact with patients, function within the healthcare system, and act as caring professionals in society. Despite the wide variability in the background of the participants, a strong consensus was reached about the strengths and gaps that were identified.
In general, the strengths of physicians include their continued knowledge and technical proficiency, as well as their ongoing commitment to the care of their patients. In comparison to the number of identified strengths, the participants identified significantly more gaps in physician preparation. These gaps, or opportunities for improvement, involve the continuum of medical education and focus on multiple issues, including physicians' ability to assess and improve quality of care, establishing competency in multiple new domains, and developing a better understanding of the healthcare system in general.
Phase 2
The second phase of ITME began with a much larger working conference, also held in Chicago, in September 2006. Attendees included representatives from those mentioned above, in addition to experts in fields that were closely aligned with the gaps identified in phase 1.
In keeping with the goal of ITME, various perspectives in medical education and healthcare were represented. Participants were assigned to one of many small groups, each group focusing on a particular gap that was consistent with the participants' area of expertise.
Using the current structure of medical education as a foundation, and considering existing funding mechanisms and the healthcare system in general, participants were asked to identify and prioritize the following in relation to their assigned gap or area for improvement:
- Changes in the system of medical education that need to occur
- Barriers that must be overcome to implement these recommended changes
- Stakeholder groups that must be engaged in order to achieve the recommended changes.
American Medical Association-Resident and Fellow Section
2006-2007 Governing Council
Sunny Ramchandani, MD, MPH, Chair
Kelly Caverzagie, MD, Vice Chair
Douglas Che Miller, MD, Secretary
David Rosman, MD, Delegate
Kimberly Ruscher, MD, Alternate Delegate
Seemal Desai, MD, Member-at-Large
Kusum Punjabi, MD, Member-at-Large
Samantha Cramoy, MD, Resident Trustee
Jon Fanning, Director, Department of Resident and Fellow Services
"Code Blue" is prepared by the Resident and Fellow Section of the AMA. Unless specifically indicated, its articles and opinions do not necessarily reflect the policy of the AMA or the opinions of the editors or the publisher of Resident & Staff Physician. This newsletter is contained in Resident & Staff Physician solely as a service to residents. The journal is not in any way involved in deciding the content of "Code Blue." All questions, suggestions, or requests for additional information should be sent to the AMA Department of Resident and Fellow Services, 515 North State Street, Chicago, IL 60610, or phone 312/464-4751. The American Medical Association-Resident and Fellow Section (AMA-RFS) is this nation's strongest voice for residents and their patients. Visit our Web page at www.ama-assn.org/go/rfs. To join or renew your membership, call the AMA-RFS at 800/AMA-3211.
This meeting yielded many recommendations for change, including modifications in premedical education and in medical school admission, faculty development and support, coordination amongst stakeholders, and a realignment of the current 3-tiered educational structure.
Phase 3
The final phase of ITME involves the implementation of ideas for short- and long-term change. This will involve the identification of priority areas, implementation of model programs, and then the evaluation of the results. The ITME leadership group is in the process of consolidating the findings of phase 2, and developing recommendations, which will be presented to the AMA House of Delegates in the upcoming months and further disseminated to other interested parties.
To view the final report for phases 1 and 2 and the plans for phase 3, please visit the AMA-RFS website at www.ama-assn.org/ama/pub/category/15.html. In addition, I will be presenting a brief educational session at the Annual Meeting of the Resident and Fellow Section Assembly from June 21-23, in Chicago about this subject. I invite you to review the ITME report, attend the assembly meeting, and give me your feedback and ideas about how to transform medical education.
Kelly J. Caverzagie, MD
Vice-Chair American Medical Association Resident and Fellow Section Member, Leadership Group, AMA Initiative to Transform Medical Education
Reference
- Caverzagie KJ. On becoming a physician. Resident & Staff Physician. 2006;52(5):43-44.
