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Overview of Medical Education Today. Charles Lockwood, MD Dean, The Ohio State University College of Medicine. Historical Perspective Current State of American Academic Medical Centers National Health Care Realities Our College of Medicine The Future . Welcome.
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Overview of Medical Education Today Charles Lockwood, MD Dean, The Ohio State University College of Medicine
Historical Perspective • Current State of American Academic Medical Centers • National Health Care Realities • Our College of Medicine • The Future Welcome
100 years ago – Abraham Flexner • 2+2 Formula • Low Tech • Teacher Centered • Physician focused Medical Education
Science and clinical practice more integrated. • High Tech • Student-Centered • Team focused MedicineEducationToday
American Association • Of Medical Colleges (AAMC) • More than131 US Medical • Schools. • Each is affiliated with large hospitals and/or medical centers and most with a university. • Take a closer look at these institutions…
AMCs are Major Providers of Healthcare • AAMC Member Teaching Hospitals represent only 6 % of all hospitals. • BUT account for: • 40% of all Medicare inpatient days • 22% of all Medicaid inpatient days • 40 % of all Hospital Charity Care
American Association of Medical Colleges They also account for: 79% of all burn center beds 40 % of neonatal intensive care beds 83% of all Level 1 regional trauma centers Overall, AAMC-member teaching hospital provide 20% of all hospital care. How is that possible? Big institutions (i.e., OSU - 6 Hospitals)
How do Medical Schools Fund their Missionof Research, Teaching and Clinical Care Source: LCME Part I-A, Annual Financial Questionnaire, FY2010
Threats - Funding the Mission NIH paylines decreasing Tuitions are too high State revenues are decreasing Reimbursement for faculty practice plans are in jeopardy Subsidies from hospitals are shrinking WHY?
Healthcare: Too Costly Health Care 24 % http://www.usgovernmentspending.com/united_states_total_spending_pie_chart
Health Care Spending Source: CMS National Health Expenditure Data, 2012
AMA AAMC CMSS AHA ABMS FSMB AHME State Boards Specialty Societies Med Schools Specialty Boards NBME MCAT USMLE Cert Exams CME Recert/MOC Subject Exams In-Training Exams (Individual in) Practice College Med School Practice Plans Residency Allopathic Training Physical Facilities LCME ACGME ACCME NCQA JCAHO
Current medical education is inefficient. Traditional medical school education takes too long, has significant waste and redundancy and does not consistently prepare students for their next step. 11 to 21 years!!! Practice Residency and Fellowships Medical School Premedical
In the face of these realities, what future should academic medicine seek to create?
Transforming Academic Medicine Will Require A Different Culture – System Based Physician
The Ohio State University College of Medicine ahead of the curve in curricular reform Rich history of curriculum innovationIn September, we will launch new Lead. Serve. Inspire Curriculum
We Offer Unique Program Opportunities Research Clinical SkillsEducation &AssessmentCenter Technology Global Health Immediate access to patients
Student Debt is a problem: • Our average debt for 2011 past year was $152,028 (not including undergrad debt) • All AAMC school average was $143,185 • Top 20 medical schools have average indebtedness of $111,590 2011 Scholarships (without a service commitment) • Our total scholarship dollars awarded was $5,804,831 • Top 20 medical schools average was $11,008,014 : Look at the Numbers
A Closer Look Residency and Fellowships Practice Premedical Medical School Ohio State $5,804,831 divided by 719 students= $8073 per student Top 20 schools provided $11,008,014 divided by an average of 575 students= $19,144 per student
Summary – Medical Education Today • Opportunities are endless.. • Systems Based Physician • Team training Integration • Technology • Community (Global) Health • Improved safety and outcomes • but, threats to outstanding medical education exist and we cannot ignore them. • Student debt • US Healthcare Costs • NIH funding • Decrease time of training and regulatory complexity of the system