Meeting the needs of today’s – and tomorrow’s – patients: Preparing medical students for an ever-changing world

The way doctors are trained is shifting in the wake of health care reform. A predicted shortage of 90,000 doctors by 2025 and an influx of patients who recently gained coverage under the Affordable Care Act (ACA) have made medical education more important than ever.

“A continually evolving health care landscape has spurred many medical schools to close the widening gap between how students are traditionally trained and the future needs of the nation’s health care system,” said Paul Ogden, M.D., interim dean of the Texas A&M Health Science Center College of Medicine.

And the Texas A&M College of Medicine is doing just that, taking a step forward to close this gap with a revamped medical curriculum. According to Ogden, the curriculum creates a more flexible and individualized approach to a traditional medical education, with a renewed emphasis on research, scholarship and the skills needed to foster lifelong medical learning.

“We want to create an educational program that trains physicians to meet the needs of today’s patients, while anticipating future changes to the system as a whole,” Ogden said.

The college introduced its new curriculum to 206 incoming medical students this summer, all of which started at the institution’s Bryan-College Station campus.

“The new curriculum will leverage our unique, multi-campus model to train a more diverse physician population to address the state’s varying patient needs,” Ogden said. “All first year students will begin their schooling in Bryan-College Station to bond as a class, learn important foundational material and develop important lifelong learning skills. The remaining three years will be conducted at one of the five clinical campuses throughout the state.” Clinical campus locations include Bryan-College Station, Round Rock, Dallas, Temple and Houston.

A recent push from the American Medical Association calls for transforming the teaching of medicine to shift focus on education toward real-world practice and competency assessment, and that’s just what the college has in store for future medical students.

The new curriculum will accelerate clinical training within the curriculum, affording students the opportunity to gain clinical experience as early as their second year of medical school, blending basic science with hands-on practice for an optimal learning experience.  Traditionally, this hands-on component of medical education begins in the third year of medical school.

“It’s about taking that basic science knowledge and putting it into the context of a clinical setting – helping them see how it fits into treating patients,” explained Diane Chico, Ph.D., assistant professor with the Texas A&M College of Medicine. “It’s about making the basic science components realistic and practical for treating patients.”

Additionally, the new curriculum will shorten the basic science content to 18 months (this component was previously two years with breaks) in order to move students into the clinical setting earlier in their educational career. The strong basic science foundation will be integral for lifeline learning and clinical education.

“Students learn differently than they did 20 years ago,” said Ruth Bush, M.D., J.D, M.P.H., vice dean for academic affairs and vice dean for the Bryan/College Station Campus. “Students want to see patients earlier in their education and get more hands-on, more quickly. These are active learners.”

Rather than faculty asking “what do I need to tell students?” students are asking “what should I be able to do?” The new curriculum will take medical education past teaching facts to creating active, adult learners who can learn from experience through a competency-based approach.

“We believe that this will not only create lifelong learners, but this will improve the efficiency and retention of medical knowledge,” Chico said.

To foster more individualism for students, the new curriculum will allow for more specialization during the fourth year of education. M4s will be able to choose “majors” to help refine and enhance their experience as they prepare to enter residency. Certifications may also be incorporated for this portion of students’ educational careers.

“By introducing majors in the fourth year, students not only get a better education, but this will produce more competitive graduates and increase their probability of going on to more prestigious residencies and careers,” Chico said.

A longitudinal track is available through the Aggie Integrated Medicine (AIM) program on the Bryan-College Station campus for third year students. Instead of concentrating on one type of clinical experience at a time, students will experience all six of the clinical experiences – family medicine, obstetrics, surgery, psychiatry, pediatrics and internal medicine – and follow patients for a year, rather than a few weeks.

According to Ogden, the goals of the new curriculum are twofold: the immediate consequence is to make graduates more competitive as they are matched with their residency assignments and then enter the job force. But long term, it’s about providing the best physicians possible.

“Of course we want our graduates to be as competitive and marketable as possible,” Ogden said. “But in the end, the most important skill we can instill in future Aggie physicians is the ability to adapt to an ever-evolving health care landscape while remaining steadfast in what matters most: providing the best care possible to our patients.”