August 25, 2006

Meeting jumpstarts talks on changes to medical curricula

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Steven Gabbe, M.D.

Meeting jumpstarts talks on changes to medical curricula

A panel of experts is working with Howard Hughes Medical Institute (HHMI) and the Association of American Medical Colleges (AAMC) to revisit what basic science content should be taught to medical students as undergraduates and as medical students.

The need to provide future physicians a strong foundation in scientific knowledge was a focus of the “HHMI-AAMC Science Education of Physicians Meeting” earlier this summer in Chevy Chase, Md., which worked to identify specific projects the HHMI, AAMC, and other partners can pursue to address the issue.

Concerns have been raised in expert panel reports, and also individually through members of the higher education community, that basic science disciplines are becoming progressively marginalized in medical education. A National Academies' report stated, “Innovation in the undergraduate biology curriculum is constrained by medical school admissions requirements.”

“Our formal training in medicine is a long process. Is there a way we can focus more on what we teach in medical school, or even shorten medical school, by changing what students are studying as undergraduates?” Vanderbilt University School of Medicine Dean Steven Gabbe, M.D., asked.

“The MCATs become important in this discussion because that test is very important for admission to medical school. You also have to consider the U.S. Medical Licensing Examinations (USMLE) because those are the tests students must pass to become licensed physicians.”

Two working groups were established at the meeting, one to review premedical science education requirements and replace specific named course requirements with defined areas of knowledge and critical skills, and a separate group to review the MCAT and consider what science content should be required.

The groups are comprised of medical school faculty, undergraduate faculty, and AAMC colleagues working on the MCAT.

The AAMC established the Institute for Improving Medical Education (IIME) due to growing concerns about the quality of medical education, which led to an IIME-appointed ad hoc committee of 10 deans charged with reviewing the state of medical education and making recommendations for reform.

Gabbe, who serves as a member of the AAMC's Ad Hoc Committee of Deans and also as co-chair of the Liaison Committee on Medical Education (LCME), presented on behalf of both committees during the meeting.

He said the Ad Hoc Committee of Deans is recommending exploring the possibility of integrating course work in the biological sciences in undergraduate and medical school programs in order to improve efficiency of the educational process.

In a separate presentation, Gabbe highlighted the LCME standards that relate to medical education, which could influence curriculum changes in medical school.

The LCME has nearly 130 accreditation standards that are constantly undergoing review and modification. There are two types of standards: 'must' standards are required by the LCME; and 'should' standards are expected unless there are extraordinary circumstances.

“It was an honor to present on behalf of those committees,” Gabbe said.

“There will probably be several task forces assembled to discuss these issues — one to look at what we need to teach to undergraduates who want to be medical students and the second one to address what we need to teach to medical students in terms of science content.”