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Academic Medicine in the 21 st Century. Richard I. Levin, MD April 16, 2008. Maclean’s #1. Science Essentials #1. Times of London. 12. 21. Marco Marra John McPherson Ken Dewar. Lister Antisepsis 1865. Lister Antisepsis 1865. Venter & Collins Human Genome 2001. Osler Graduates
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Academic Medicine in the 21st Century Richard I. Levin, MD April 16, 2008
Maclean’s#1 • Science Essentials#1 • Times of London 12 21
Marco Marra John McPherson Ken Dewar ListerAntisepsis 1865 ListerAntisepsis 1865 Venter & Collins Human Genome 2001 Osler Graduates 1872 Osler Graduates 1872 RoddickAsepsis 1877 RoddickAsepsis 1877 Long Ether 1842 Long Ether 1842 Hippocrates 460 BC Harvey Circulation 1628 Harvey Circulation 1628 Hoffman Aspirin 1893 Hoffman Aspirin 1893 Fleming Penicillin 1928 MRI 1980 WHO Smallpox 1977 Penfield Montreal Procedure 1930s Oldendorf & Hounsfield CAT Scan 1972 Watson & Crick Double Helix 1953 Avery DNA 1944 Sabiston CABG 1962 Hippocrates 460 BC Flexner Report 1910 460 BC 2008 AD
Challenges to Academic Medicine • Education • Research • Care
“The way we … provide instruction is essentially the same as it was when our Founding Fathers went to school...we still educate our students based on an agricultural timetable, in an industrial setting, yet tell students they live in a digital age.” Paige, 2002
Expansion of Medical Knowledge 80% of scientists who ever lived, live now 2000 pages of textadded every minute 1 days output =5 yrs reading Knowledge doublesevery 7 years
Challenges to Medical Education at theDawn of the 21st Century Inadequate Resources Expansion of Medical Knowledge Time in the human classroom of the hospital has vanished
TEACHING HOSPITAL FACULTY STUDENTS RESIDENTS PATIENTS DIAGNOSTICS, TREATMENTS, RECOVERY 1900 - 1990
TEACHING HOSPITAL OFFICES FACULTY STUDENTS RESIDENTS PATIENTS CONSULTATIONS DIAGNOSTIC CENTERS AMBULATORY SURGERY 2008
Challenges to Academic Medicine • Education • Research • Care
Era of Great Risk New Epidemic of Obesity and Diabetes
Costs per Capita in OECD Countries Canadian health care costs have TRIPLED since 1975 National Health Expenditure Trends, 1975–2007 CIHI
Graph 6 Public Health Spending Projections, 2007-08 to 2017-18 (in millions of dollars) Growth of health spending based on current trends (5.8%) Increase in health spending based on current rate of economic growth (3.9%) 42,0 2008 Task Force Report on the Financing of the Health System Castonguay, Venne & Marcotte
RUIS Current System MUHC JGH St. Mary’s Douglas Teaching Affiliates
McGill Academic Health Network • Coordinate education, research and care • Recognize special areas of excellence • Capture, elevate and publicize its power
McGill Academic Health Network RUIS Douglas MUHC St. Mary’s JGH McGill Academic Health Network Teaching Affiliates