There is a time in the life of every organization when what has always brought success is no longer sufficient to meet growing expectations. Harvard Business Review is replete with articles describing why CEOs and businesses must fundamentally reinvent themselves to maintain competitiveness, or fall from grace in The Marketplace. Common themes involve old companies adopting new digital platforms to anticipate their customer’s buying needs before they even know them themselves. Indeed, as featured in Forbes on September 7th, the giants of cloud-based big data capture and predictive analytics have harnessed the massive computing power of Hadoop to project future trends and to create competitive niches.
Academic medicine does not yet move easily in this high-tech space.
Perhaps, it’s a form of battle fatigue born of recurrent painful “learning” interactions with the electronic health record (EHR) de jour that contributes to medicine’s general ennui. Or could it be a healthy skepticism of the bombardment of health “breakthroughs” from Big Pharma and med-tech giants as to their actual value in patient care? In general, while medical practice likes true health care innovations, medical education has not traditionally been an early adopter of novel technologies.
That being said, there are some potent exceptions: simulation and clinical skills capabilities have grown in a practical response to the decline in hospital patient census and length of stay; Whiteboards/SMART Boards™ and lecture capture tools provide professors and students with greater learning environment; and computer-based testing facilities are making exam proctors extinct. But such content delivery and assessment technologies do not per se foster the skill of lifelong learning.
When it comes to real innovation in the med-ed curriculum space, most medical schools are dinosaurs.
Now is the time to change that.
Given the massive universe of scientific facts and biomedical information currently shaping the practice of modern medicine, and the projected rapid expansion of The Gene (Siddhartha Mukherjee) and precision medicine in the near future, it is clear to all that the passive rote memory of endless facts and the “see one, do one, teach one” apprenticeship model are unsustainable educational approaches. Like the Fortune 500 companies adopting Fintech algorithm-based on-line customer services and cyber-attack defenses, the “AAMC 150” must come to grips with medical students’ needs for skill building and lifelong learner resilience. Business failure is the price exacted by The Marketplace via falling share prices and failed IPOs. The price of med-ed failure is measured by growing student suicide rates and nearly 40 percent physician burnout.
As such, the Liaison Committee on Medical Education (LCME) takes skill building very seriously and so does NYMC.
Before receiving the LCME’s final decision regarding NYMC School of Medicine’s re-accreditation, the faculty and students of our Educational Curriculum Committee (ECC) began the challenging task of redesigning our M.D. curriculum to reduce pre-clinical years’ lecture content to less than 50 percent of their curriculum per year. The SOM’s Office of Undergraduate Medical Education (UME) held its annual curriculum planning retreat to introduce validated digital technologies and novel clerkship approaches designed to enhance active learning and promote the integration of clinical skills. We’ve enlightened the Faculty Senate, Student Senate, the Board of Trustees and the College’s senior leadership about the strategic imperative for transformation of our M.D. curriculum.
Incremental curriculum change, once “good enough for government work,” is no longer sufficient.
Our students, our faculty and our administration must push boldly ahead into the modern era of medical education. The M.D. curriculum must evolve to meet the expectations of our accrediting body the LCME, and that meets the career development needs of our students and faculty. The SOM’s new Curriculum Redesign Task Force will develop the FY17-18 budget and operating plan to implement required upgrades and foster true innovation. This Task Force will also inform the ECC’s AY17-18 discussions on curriculum redesign.
When all is said and done, our School will report its commitment to this task and its progress to the LCME in December 2017.
Now is not the time for timidity, and failure to act is not an option.
In the end, over the next two years, we will follow our SOM’s strategic plan and do what great medical education schools do. We will prepare NYMC M.D. graduates for the needs of society, building the skills that will make them and their future patients healthier.
D. Douglas Miller, M.D., C.M., M.B.A.
Dean, School of Medicine
New York Medical College