Leading Medical Education Reform

reprinted from Issue 12, Spring 2011 of Frontiers of Medicine (PDF)

Talmadge E. King, Jr., MD
photo by Noah Berger

While the public discourse about healthcare reform has garnered much of the national headlines, the movement to reform medical education – led by many of the UCSF’s Department of Medicine’s faculty, students and trainees – will have a significant impact on the public’s healthcare experience. People who decide to become doctors come from a wider array of backgrounds than ever before. We welcome this development as it matches the growing diversity of our patient population. But the complexity of modern medicine, the focus to have the experience more patient centered and the desire to not have medical education be a one-sizefits- all approach necessitated changes be made in how we educate our students and develop our faculty.

A surprise to no one familiar with the Department’s extraordinary body of talent, the Carnegie Foundation invited Molly Cooke, MD, David Irby, PhD, and Bridget O’Brien, PhD, to prepare a new report which outlines a vision of improving medical education. This report resulted in a book, Educating Physicians: A Call for Reform of Medical School and Residency and represents just the second comprehensive review of the medical education system.

Some of the best practices that Molly, Dave and Bridget observed nationally at 14 medical schools across the country were brought back to UCSF and developed into new educational programs here in the Department. Two of these programs, PISCES and Pathways, are profiled in our cover story. An in depth look at other innovative educational programs will be part of an ongoing series in future Frontiers of Medicine issues.

In the Department’s strategic plan, one of the goals in the educational priority is “…to develop a new model of medical education, based on coordination across sites and programs, applications of learning theory, exposure to subspecialties and career pathways.” The programs mentioned above are clearly in line with these goals and we were happy to learn in January that the San Francisco Veterans Affairs Medical Center was one of five VA Medical Centers nationally to receive a grant to establish a Center of Excellence in Primary Care Education. Part of VA’s New Models of Care initiative, the centers will utilize VA primary care settings to develop and test innovative approaches to prepare physician residents and students, advanced practice nurse and undergraduate nursing students, and associated health trainees for primary care practice in the 21st century. This will give the Department an opportunity to work with the other professional programs across UCSF, particularly in the School of Nursing.

Grants like those offered by the Department of Veterans Affairs to establish the Center for Excellence are unfortunately few and far between. Good medical education involving individual mentoring and hands-on teaching is an expensive enterprise. The innovative programs we offer enable the UCSF Department of Medicine to maintain its national preeminence in attracting the best and brightest students, residents and fellows. Your generous support will help us continue to foster the kind of educational excellence that makes UCSF consistently rank among the top medical schools in the country.


Talmadge E. King, Jr., MD
Chair, Department of Medicine
Julius R. Krevans Distinguished Professorship in Internal Medicine

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