Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.
"Today's physician education system produces trained doctors with strong scientific underpinnings in biological and physical sciences as well as supervised practical experience in delivering care. Significant financial public support underlies the graduate-level training of the nation's physicians. Two federal programs--Medicare and Medicaid--distribute billions each year to support teaching hospitals and other training sites that provide graduate medical education. Graduate Medical Education That Meets the Nation's Health Needs is an independent review of the goals, governance, and financing of the graduate medical education system. This report focuses on the extent to which the current system supports or creates barriers to producing a physician workforce ready to provide high-quality, patient-centered, and affordable health care and identifies opportunities to maximize the leverage of federal funding toward these goals. Graduate Medical Education examines the residency pipeline, geographic distribution of generalist and specialist clinicians, types of training sites, and roles of teaching and academic health centers. The recommendations of Graduate Medical Education will contribute to the production of a better prepared physician workforce, innovative graduate medical education programs, transparency and accountability in programs, and stronger planning and oversight of the use of public funds to support training. Teaching hospitals, funders, policy makers, institutions, and health care organizations will use this report as a resource to assess and improve the graduate medical education system in the United States"--Publisher's description.
Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10â€"11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.
Because of changes in the health care system, the hospital has become less suitable as the primary focus of graduate medical education for primary care physicians. However, the current system of financing health care education and services makes it difficult to accomplish the needed shift to training in primary care ambulatory settings. This book suggests ways of lowering financial barriers to primary care training in ambulatory settings.
Public health efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective public health interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of public health physicians who are prepared to face today's public health challenges. Training Physicians for Public Health Careers focuses on the critical roles that physicians play in maintaining and strengthening the public health system, identifies what these physicians need to know to engage in effective public health actions, explores the kinds of training programs that can be used to prepare physicians for public health roles, and examines how these training programs can be funded. Medical schools, schools of public health, health care and public health care professionals, medical students and students of public health will find this of special interest.
Providing a comprehensive and evidence-based reference guide for those who have a strong and scholarly interest in medical education, the Oxford Textbook of Medical Education contains everything the medical educator needs to know in order to deliver the knowledge, skills, and behaviour that doctors need. The book explicitly states what constitutes best practice and gives an account of the evidence base that corroborates this. Describing the theoretical educational principles that lay the foundations of best practice in medical education, the book gives readers a through grounding in all aspects of this discipline. Contributors to this book come from a variety of different backgrounds, disciplines and continents, producing a book that is truly original and international.
PRAISE FOR EDUCATING PHYSICIANS "Educating Physicians provides a masterful analysis of undergraduate and graduate medical education in the United States today. It represents a major educational document, based firmly on educational psychology, learning theory, empirical studies, and careful personal observations of many individual programs. It also recognizes the importance of financing, regulation, and institutional culture on the learning environment, which suffuses its recommendations for reform with cogency and power. Most important, like Abraham Flexner's classic study a century ago, the report recognizes that medical education and practice, at their core, are profoundly moral enterprises. This is a landmark volume that merits attention from anyone even peripherally involved with medical education." —Kenneth M. Ludmerer, author, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care "This is a very important book that comes at a critical time in our nation's history. We will not have enduring health care reform in this country unless we rethink our medical education paradigms. This book is a call to arms for doing just that." —George E. Thibault, president, Josiah Macy, Jr. Foundation "The authors provide us with the evidence-based model for physician education with associated changes in infrastructure, policy, and our roles as educators. Whether you agree or not with their conclusions, if you are a teacher this book is a must-read as it will frame both what and how we discuss medical education throughout the current century." —Deborah Simpson, associate dean for educational support and evaluation, Medical College of Wisconsin "A provocative book that provides us with a creative vision for medical education. Using in-depth case studies of innovative educational practices illustrating what is actually possible, the authors provide sage advice for transforming medical education on the basis of learning theories and educational research." —Judith L. Bowen, professor of medicine, Oregon Health & Science University
The United States is rapidly transforming into one of the most racially and ethnically diverse nations in the world. Groups commonly referred to as minorities-including Asian Americans, Pacific Islanders, African Americans, Hispanics, American Indians, and Alaska Natives-are the fastest growing segments of the population and emerging as the nation's majority. Despite the rapid growth of racial and ethnic minority groups, their representation among the nation's health professionals has grown only modestly in the past 25 years. This alarming disparity has prompted the recent creation of initiatives to increase diversity in health professions. In the Nation's Compelling Interest considers the benefits of greater racial and ethnic diversity, and identifies institutional and policy-level mechanisms to garner broad support among health professions leaders, community members, and other key stakeholders to implement these strategies. Assessing the potential benefits of greater racial and ethnic diversity among health professionals will improve the access to and quality of healthcare for all Americans.
This stimulating open access volume details the innovative work of the Pan Institution Network for Global Health in creating collaborative research-based answers to large-scale health issues. Equitable partnerships among member universities representing North America, Africa, Asia, and Europe reverse standard cross-national dynamics to develop locally relevant responses to health challenges as well as their underlying disparities. Case studies focusing on multiple morbidities and effects of urbanization on health illustrate open dialogue in addressing HIV, maternal/child health, diabetes, and other major concerns. These instructive examples model collaborations between global North and South as meaningful steps toward the emerging global future of public health. Included in the coverage: Building sustainable networks: introducing the Pan Institution Network for Global Health Fostering dialogues in global health education: a graduate and undergraduate approach Provider workload and multiple morbidities in the Caribbean and South Africa Project Redemption: conducting research with informal workers in New York City Partnership and collaboration in global health: valuing reciprocity Global Health Collaboration will interest faculty working within the field of global health; scholars within public health, health policy, and cognate disciplines; as well as administrators looking to develop international university partnerships around global health and graduate students in the areas of global health, health administration, and public health and related social sciences (e.g., sociology, anthropology, demography).
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
